Correlation of the pilo-pupil ratio average, a new test for autonomic denervation, to the severity of diabetic retinopathy.
OBJECTIVE
To evaluate the association between the degree of diabetic retinopathy and autonomic neuropathy, and to test whether ocular parasympathetic denervation is correlated to the degree of diabetic retinopathy.


METHODS
Cross-sectional pilot study.


METHODS
The tertiary ophthalmic centre for the Atlantic provinces in Halifax.


METHODS
Twelve randomly selected patients (six women and six men with a mean age of 36.6 years) with insulin-dependent diabetes mellitus who had diabetic retinopathy.


METHODS
Degree of diabetic retinopathy, hemoglobin Alc level, orthostatic change in systolic and diastolic blood pressure and in serum catecholamine levels, degree of pupillary supersensitivity to 0.125% pilocarpine (pilo-pupil ratio average [PPRA]).


RESULTS
The degree of diabetic retinopathy was significantly correlated with the duration of diabetes (p = 0.035), the hemoglobin Alc level (p = 0.004), the orthostatic change in diastolic blood pressure (p = 0.022) and the PPRA (p = 0.0007).


CONCLUSIONS
The degree of diabetic retinopathy was significantly correlated with autonomic neuropathy and with the PPRA. Given these results, further study is indicated to determine whether autonomic neuropathy is a predictor of the severity of diabetic retinopathy.
Sharma
S
S
Department of ophthalmology, Queen's University, Kingston, Ont.
Hoskin-Mott
A
A
Benstead
T
T
Maxner
C
C
D000328:Adult; D017763:Autonomic Denervation; D001342:Autonomic Nervous System Diseases / Q000175:diagnosis* / Q000503:physiopathology; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure; D002395:Catecholamines / Q000097:blood; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications; D003930:Diabetic Retinopathy / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007498:Iris / Q000294:innervation*; D008297:Male; D008875:Middle Aged; D009883:Ophthalmic Solutions; D010275:Parasympathetic Nervous System / Q000187:drug effects / Q000503:physiopathology; D010277:Parasympathomimetics; D010862:Pilocarpine; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011680:Pupil / Q000187:drug effects* / Q000502:physiology; D012189:Retrospective Studies
D001786:Blood Glucose; D002395:Catecholamines; D009883:Ophthalmic Solutions; D010277:Parasympathomimetics; D010862:Pilocarpine