Macular circulation in patients with diabetes mellitus with and without arterial hypertension.
BACKGROUND
Previous fluorescein angiographic studies have shown alterations in the macular microcirculation in patients with diabetes mellitus and arterial hypertension. In both diseases capillary blood velocity was reduced and capillary density decreased. These changes were more pronounced in diabetic patients. We have examined the influence of arterial hypertension in combination with diabetes mellitus.


METHODS
62 patients with diabetes mellitus and arterial hypertension (group 1) were matched with patients with diabetes mellitus but without arterial hypertension (group 2, match criteria: ETDRS stage of retinopathy). In all subjects fluorescein angiograms were performed with a scanning laser ophthalmoscope. Macular capillary blood velocity (CBV), perifoveal intercapillary area (PIA), the coefficient of variation of both parameters, the area of the foveal avascular zone (FAZ), and the arteriovenous passage time (AVP) were assessed by digital image analysis.


RESULTS
Systolic and diastolic blood pressures were significantly increased in the patients with arterial hypertension (systolic p=0.0008; diastolic p=0.03). Neither dynamic measures (AVP: 1.64 (0.49) seconds (group 1), 1.72 (0.58) seconds (group 2); CBV: 1.98 (0.39) mm/s (group 1), 2.09 (0.43) mm/s (group 2)) nor morphological measures (PIA: 7985 (3137) microm(2) (group 1), 8338 (3376) microm(2) (group 2); FAZ: 0.319 (0.206) mm(2) (group 1), 0.363 (0.237) mm(2) (group 2)) were significantly different between the two groups of diabetic patients.


CONCLUSIONS
Arterial hypertension did not result in more severe macular capillary dropout than diabetes without hypertension. This might be explained by the fact that most of the patients were being treated with antihypertensive drugs.
Arend
O
O
Department of Ophthalmology, Medical School, Technical University Aachen, Pauwelsstrasse 30, 52057 Aachen, Germany. Arend@RWTH-Aachen.de
Rüffer
M
M
Remky
A
A
D000328:Adult; D000704:Analysis of Variance; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D002196:Capillaries / Q000503:physiopathology; D003930:Diabetic Retinopathy / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000503:physiopathology*; D008266:Macula Lutea / Q000098:blood supply*; D008297:Male; D008833:Microcirculation / Q000502:physiology; D008875:Middle Aged