Protective effect of captopril on the blood-retina barrier in normotensive insulin-dependent diabetic patients with nephropathy and background retinopathy.
The effect of 18 months' inhibition of angiotensin-converting enzyme by captopril on the leakage of fluorescein through the blood-retina barrier was examined in a prospective, randomized control study of 20 normotensive insulin-dependent diabetic patients with nephropathy and background retinopathy. After 18 months, 15 patients remained in the study. Fluorescein leakage remained nearly unchanged in the captopril-treated group, being 4.1 +/- 4.1 (mean +/- SD) x 10(-7) cm/s at baseline and 4.2 +/- 4.1 x 10(-7) cm/s after 18 months' treatment. The permeability increased significantly (P less than 0.01) from 3.3 +/- 2.2 x 10(-7) cm/s to 5.6 +/- 3.5 x 10(-7) cm/s at 18 months in the control group. Arterial blood pressure was nearly constant in both groups throughout the study. The results indicate that angiotensin-converting enzyme inhibition with captopril can arrest or delay a progressive breakdown of the blood-retina barrier in normotensive insulin-dependent diabetic patients with nephropathy and background retinopathy.
Larsen
M
M
Department of Ophthalmology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark.
Hommel
E
E
Parving
H H
HH
Lund-Andersen
H
H
D000328:Adult; D001786:Blood Glucose / Q000187:drug effects; D001794:Blood Pressure / Q000187:drug effects; D001813:Blood-Retinal Barrier / Q000187:drug effects*; D002216:Captopril / Q000627:therapeutic use*; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D003928:Diabetic Nephropathies / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D019793:Fluorescein; D005452:Fluoresceins / Q000493:pharmacokinetics; D006444:Hemoglobin C / Q000378:metabolism; D006801:Humans; D008297:Male; D010539:Permeability; D011446:Prospective Studies
D001786:Blood Glucose; D005452:Fluoresceins; D006444:Hemoglobin C; D002216:Captopril; D019793:Fluorescein