title: Nitric oxide and oxidative stress is associated with severity of diabetic retinopathy and retinal structural alterations.
abstract: BACKGROUND
  The aim of the study was to determine plasma nitric oxide (NO) and lipid peroxide (LPO) levels in diabetic retinopathy and its association with severity of disease.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  A total of 60 consecutive cases and 20 healthy controls were included.
  
  
  METHODS
  Severity of retinopathy was graded according to early treatment diabetic retinopathy study (ETDRS) classification. Photoreceptor inner segment ellipsoid band (ISel) disruption and retinal pigment epithelium (RPE) alteration were graded using spectral domain optical coherence tomography. Data were statistically analyzed.
  
  
  METHODS
  Plasma thiobarbituric acid reactive substances, NO assay and reduced glutathione (GSH) were measured using standard protocol.
  
  
  RESULTS
  Increased severity of diabetic retinopathy was significantly associated with increase in plasma levels of LPO (P < 0.05), NO (P < 0.001) and decrease in plasma levels of GSH (P < 0.0001), ISel disruption (P < 0.001) and RPE topographic alteration (P < 0.01).
  
  
  CONCLUSIONS
  Increased plasma NO levels are associated with increased severity of diabetic retinopathy. For the first time, it has been demonstrated that increased plasma LPO, NO and decreased GSH levels are associated with in vivo structural changes in inner segment ellipsoid and RPE.
authors: Retina Service, Department of Ophthalmology, King George's Medical University, Lucknow, India.
authors: Shashi
authors: S
authors: Sharma
authors: Retina Service, Department of Ophthalmology, King George's Medical University, Lucknow, India.
authors: Sandeep
authors: S
authors: Saxena
authors: Retina Service, Department of Ophthalmology, King George's Medical University, Lucknow, India.
authors: Khushboo
authors: K
authors: Srivastav
authors: Developmental Toxicology Division, Indian Institute of Toxicology and Research, Lucknow, India.
authors: Rajendra K
authors: RK
authors: Shukla
authors: Retina Service, Department of Ophthalmology, King George's Medical University, Lucknow, India.
authors: Nibha
authors: N
authors: Mishra
authors: Department of Ophthalmology, Pallas Klinik, Olten, Switzerland.
authors: Carsten H
authors: CH
authors: Meyer
authors: Department of Cardiovascular Diseases, International Clinical Research Center, St Anne's University Hospital and Masaryk University, Brno, Czech Republic.
authors: Peter
authors: P
authors: Kruzliak
authors: Developmental Toxicology Division, Indian Institute of Toxicology and Research, Lucknow, India.
authors: Vinay K
authors: VK
authors: Khanna
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D003930:Diabetic Retinopathy / Q000503:physiopathology*; D005260:Female; D005978:Glutathione / Q000097:blood; D006801:Humans; D015227:Lipid Peroxidation; D008054:Lipid Peroxides / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000097:blood*; D018384:Oxidative Stress; D011446:Prospective Studies; D055211:Retinal Photoreceptor Cell Inner Segment / Q000473:pathology*; D055213:Retinal Pigment Epithelium / Q000473:pathology*; D012720:Severity of Illness Index; D017392:Thiobarbituric Acid Reactive Substances / Q000378:metabolism; D041623:Tomography, Optical Coherence
chemical_list: D008054:Lipid Peroxides; D017392:Thiobarbituric Acid Reactive Substances; D009569:Nitric Oxide; D005978:Glutathione
keywords: diabetic retinopathy; nitric oxide; nitrosative stress; oxidative stress; spectral domain optical coherence tomography