Blood-retina barrier permeability in diabetes during acute ACE-inhibition.
We assessed the acute effect of ACE-inhibition (captopril) on blood-retina barrier (BRB) permeability in 10 hypertensive insulin-dependent diabetic patients with background retinopathy in a double-masked placebo controlled cross-over study. All patients underwent ophthalmological examination, fundus photography, fluorescein angiography, vitreous fluorometry, and continuous blood pressure recording within 3 h of the drug/placebo administration. The decrease in mean arterial blood pressure, from placebo treatment 149/92 +/- 17/7 to captopril treatment 132/83 +/- 14/7 mmHg (mean +/- SD), P less than 0.01 was not accompanied by a significant decrease in BRB permeability, which was 2.51 (1.24-9.15) with placebo and 3.02 (1.25-13.93).10(-7) cm/s during captopril treatment (geometric mean and-range), NS. Our study suggests that abnormal leakage through the BRB in hypertensive insulin-dependent diabetic patients with background retinopathy is caused predominantly by structural changes in the retinal vessels whereas hydrostatic forces play a minor role.
Engler
C B
CB
Department of Ophthalmology, Gentofte Hospital, University of Copenhagen, Denmark.
Parving
H H
HH
Mathiesen
E R
ER
Larsen
M
M
Lund-Andersen
H
H
D000328:Adult; D000419:Albuminuria / Q000652:urine; D001813:Blood-Retinal Barrier; D002216:Captopril / Q000493:pharmacokinetics*; D002463:Cell Membrane Permeability; D003922:Diabetes Mellitus, Type 1 / Q000378:metabolism*; D003930:Diabetic Retinopathy / Q000378:metabolism*; D004311:Double-Blind Method; D005260:Female; D019793:Fluorescein; D005451:Fluorescein Angiography; D005452:Fluoresceins / Q000493:pharmacokinetics; D015590:Fluorophotometry; D006801:Humans; D006973:Hypertension / Q000378:metabolism* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged
D005452:Fluoresceins; D002216:Captopril; D019793:Fluorescein