Capillary pressure may predict preclinical changes in the eye.
OBJECTIVE
Microvascular dysfunction is associated with end-organ damage. Macular oedema is an important component of diabetic retinopathy. Macular thickness can be accurately quantified by optical coherence tomography (OCT), enabling accurate assessment of the macular prior to clinically apparent abnormalities. We investigated whether macular (fovea) thickness in non-diabetic individuals is related to the microvascular variables controlling fluid filtration across a blood vessel wall, in particular capillary pressure and the microvascular filtration capacity (Kf).


METHODS
We recruited 50 non-diabetic individuals (25 men, 25 women; age range: 26-78 years; BMI range: 20-46 kg/m(2)). Fovea thickness was assessed by OCT. Microvascular assessments included: finger nailfold capillary pressure; Kf; microvascular structural assessments, i.e. skin vasodilatory capacity, minimum vascular resistance (MVR) and microvascular distensibility; and endothelial function.


RESULTS
At 214.6 (19.9) microm (mean [SD]), fovea thickness was within normal range. Capillary pressure, adjusted for BMI, was associated with fovea thickness (standardised beta 0.573, p = 0.006, linear regression). Fovea thickness was not associated with Kf, microvascular structural assessments or endothelial function. Capillary pressure was still associated with fovea thickness when adjusted for microvascular variables (Kf, vasodilatory capacity, MVR, microvascular distensibility or endothelial function), or for risk factors for diabetes (systemic blood pressure, insulin sensitivity, inflammation, glycaemic status and lipids) and age.


CONCLUSIONS
Capillary pressure, a key determinant of movement of fluid across a blood vessel wall, is associated with fovea thickness in non-diabetic individuals. This suggests that with regard to potential preventative or therapeutic targets, attention should be directed at the mechanisms determining retinal microvascular pressure.
Diabetes and Vascular Medicine, Institute of Biomedical and Clinical Science, Peninsula Medical School, Exeter, UK. kim.gooding@pms.ac.uk
K M
KM
Gooding
J E
JE
Tooke
H
H
von Lany
M
M
Mitra
R
R
Ling
C I
CI
Ball
D
D
Mawson
K
K
Skinner
A C
AC
Shore
D000328:Adult; D000368:Aged; D003930:Diabetic Retinopathy / Q000175:diagnosis / Q000503:physiopathology*; D005260:Female; D005584:Fovea Centralis / Q000098:blood supply; D006801:Humans; D008266:Macula Lutea / Q000098:blood supply*; D008269:Macular Edema / Q000175:diagnosis / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009765:Obesity; D041623:Tomography, Optical Coherence