title: Correlation of conjunctival microangiopathy with retinopathy in type-2 diabetes mellitus (T2DM) patients.
abstract: We hypothesized that T2DM vasculopathy can be revealed and quantified in the bulbar conjunctiva prior to its pathologic presentation in the retina. Using computer-assisted intravital microscopy (CAIM), an objective, non-invasive approach can provide a viable complement to retinal fundus photography to possibly screen patients for early signs of real-time, in vivo T2DM vasculopathy. Fundus photography was utilized to determine the retinopathy level (RL) in T2DM patients with non-proliferative diabetic retinopathy (NPDR) and control subjects. CAIM was used to quantify microangiopathy in the bulbar conjunctiva in the same patients, and reported on a severity index (SI). The average RL for the T2DM patients in this study is 19.68 ± 9.91, which differs from control subjects (RL = 10 ± 0.0; p < 0.05). A significant difference in vasculopathy was observed in the conjunctival microcirculation in the same patients (SI = 5.81 ± 1.30) when compared with control subjects (SI = 1.33 ± 1.58; p < 0.05). The results provide evidence that significant vasculopathy had developed in the microcirculation in the bulbar conjunctiva, though diabetic retinopathy had not developed significantly in the same patients - indicative of the presence of a time window for early intervention of T2DM before non-proliferative retinopathy develops, and the real-time availability of the conjunctival microvasculature as an in vivo platform to monitor disease progression.
authors.affiliation: Department of Medical Pathology, University of California, Davis Medical Center, Sacramento, 95817, USA. wilson.to@ucdmc.ucdavis.edu
authors.forename: Wilson J
authors.initials: WJ
authors.lastname: To
authors.forename: David G
authors.initials: DG
authors.lastname: Telander
authors.forename: Maureen E
authors.initials: ME
authors.lastname: Lloyd
authors.forename: Peter C Y
authors.initials: PC
authors.lastname: Chen
authors.forename: Anthony T W
authors.initials: AT
authors.lastname: Cheung
mesh_terms: D000328:Adult; D000368:Aged; D003228:Conjunctiva / Q000098:blood supply* / Q000473:pathology*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D003925:Diabetic Angiopathies / Q000175:diagnosis*; D003930:Diabetic Retinopathy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008833:Microcirculation; D008853:Microscopy / Q000379:methods; D008875:Middle Aged; D055815:Young Adult