title: Improvement of mild retinopathy in type 2 diabetic patients correlates with narrowing of retinal arterioles. A prospective observational study.
abstract: OBJECTIVE
  Diabetic retinopathy is one of the leading causes of blindness in the Western world. The disease is characterized by morphological lesions secondary to disturbances in retinal blood flow assumed to be related to disturbances in retinal autoregulation. However, there is a need for elucidating the relation between disturbances in diameter regulation of retinal vessels and the development of diabetic retinopathy in longitudinal studies.
  
  
  METHODS
  Sixty-four patients with type 2 diabetes mellitus were subjected to measurement of pressure autoregulation of retinal arterioles using the Dynamic Vessel Analyzer (DVA) and measurement of retinal thickness using OCT scanning, and after a mean of 6.8 years, 42 of the patients were re-examined. The vascular response was compared in patients in whom retinopathy had disappeared, was unchanged, or had worsened.
  
  
  RESULTS
  At baseline, hemoglobin A1c (HbA1c) was significantly higher in the patients who would later experience worsening of diabetic retinopathy than in the other groups, but had been reduced at the follow-up examination. During the follow-up period, the resting diameter of retinal arterioles decreased significantly in the patients who experienced improvement in diabetic retinopathy but was unchanged in the other groups, whereas both the diameter response of retinal arterioles to isometric exercise and retinal thickness increased non-significantly with worsening of retinopathy.
  
  
  CONCLUSIONS
  The development of diabetic retinopathy is related to the diameter of retinal arterioles. Future clinical intervention studies should aim at investigating the effects of normalizing arteriolar diameters in diabetic retinopathy.
authors.affiliation: Department of Ophthalmology, Aarhus University Hospital, 8000, Aarhus C, Denmark, line.pedersen@ki.au.dk.
authors.forename: Line
authors.initials: L
authors.lastname: Pedersen
authors.forename: Peter
authors.initials: P
authors.lastname: Jeppesen
authors.forename: Søren Tang
authors.initials: ST
authors.lastname: Knudsen
authors.forename: Per Løgstrup
authors.initials: PL
authors.lastname: Poulsen
authors.forename: Toke
authors.initials: T
authors.lastname: Bek
mesh_terms: D001160:Arterioles / Q000473:pathology; D001794:Blood Pressure / Q000502:physiology; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003930:Diabetic Retinopathy / Q000503:physiopathology*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012161:Retinal Artery / Q000473:pathology*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology
chemical_list: D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human