title: Retinal white blood cell flux and systemic blood pressure in patients with type 1 diabetes.
abstract: OBJECTIVE
  There is evidence that altered retinal blood flow and altered retinal blood flow regulation play a role in the development and progression of diabetic retinopathy. We compared the association between systemic blood pressure and retinal white blood cell flux in patients with type 1 diabetes and healthy control subjects.
  
  
  METHODS
  The study was performed in 100 patients with type 1 diabetes with no or minimal diabetic retinopathy and a group of 313 age-matched healthy controls. Inclusion criteria were systolic blood pressure ≤ 160 mmHg and diastolic blood pressure ≤ 95 mmHg. None of the subjects took vasoactive medication except insulin. The blue field entoptic technique was used to assess retinal white blood cell flux, velocity and density in the perimacular region. Pressure-flow relationships were calculated for both groups to assess differences in blood flow regulation.
  
  
  RESULTS
  Retinal white blood cell flux was comparable between the two study groups. Both type 1 diabetic patients and healthy subjects showed a significant positive correlation between retinal white blood cell flux and mean arterial pressure (diabetic patients: r=0.48; p<0.05, healthy subjects r=0.28). The correlation coefficients between mean arterial pressure and white blood cell flux were significantly higher in patients with diabetes than in the healthy control group (p=0.0459).
  
  
  CONCLUSIONS
  Retinal white blood cell flux, as assessed with the blue-field entoptic technique, is not significantly different between type 1 diabetic patients with no or minimal retinopathy and healthy control subjects. Type 1 diabetic subjects do, however, show an abnormal association between systemic blood pressure and retinal white blood cell flux. This indicates altered autoregulation in early diabetic retinopathy.
authors.affiliation: Department of Clinical Pharmacology, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria.
authors.forename: Stefan
authors.initials: S
authors.lastname: Palkovits
authors.forename: Gabriele
authors.initials: G
authors.lastname: Fuchsjäger-Mayrl
authors.forename: Alexandra
authors.initials: A
authors.lastname: Kautzky-Willer
authors.forename: Sibylla
authors.initials: S
authors.lastname: Richter-Müksch
authors.forename: Ana
authors.initials: A
authors.lastname: Prinz
authors.forename: Veronika
authors.initials: V
authors.lastname: Vécsei-Marlovits
authors.forename: Gerhard
authors.initials: G
authors.lastname: Garhöfer
authors.forename: Leopold
authors.initials: L
authors.lastname: Schmetterer
mesh_terms: D000328:Adult; D001783:Blood Flow Velocity / Q000502:physiology; D001786:Blood Glucose / Q000378:metabolism; D001794:Blood Pressure / Q000502:physiology*; D003922:Diabetes Mellitus, Type 1 / Q000503:physiopathology*; D003930:Diabetic Retinopathy / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006706:Homeostasis; D006801:Humans; D007429:Intraocular Pressure / Q000502:physiology; D017078:Laser-Doppler Flowmetry; D007962:Leukocytes / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D012171:Retinal Vessels / Q000503:physiopathology*; D014065:Tonometry, Ocular; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human