Effect of morphological abnormalities on blood retinal barrier permeability in diabetic retinopathy |
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Authors: | Johannes M A Van Gerven Johan P Boot Herman H P J Lemkes Jaap A Van Best PhD |
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Affiliation: | (1) Department of Endocrinology & Metabolic Diseases, University Hospital, Leiden, The Netherlands;(2) Department of Ophthalmology, University Hospital, Leiden, The Netherlands;(3) Department of Ophthalmology, University Hospital, Rijnsburgerweg, 10, 2333 AA Leiden, The Netherlands |
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Abstract: | The morphological base for the impaired function of the blood retinal barrier was studied in 50 eyes of 10 insulin dependent and 21 non-insulin dependent patients with various levels of diabetic retinopathy. The permeability of the blood retinal barrier (PBRB) was determined by vitreous fluorophotometry with correction for autofluorescence, lenstransmission and non-protein bound plasma fluorescein concentration. Morphological abnormalities of diabetic retinopathy assessed by fundus photography and fluorescein angiography were individually scored on a decimal scale and related to the PBRB by multiple regression analysis. The Pbrb was not correlated to morphological abnormalities of non-proliferative retinopathy (1) microaneurysms, (2) hard exudates, (3) soft exudates, (4) intraretinal hemorrhages, (5) fluorescein leakage, and (6) capillary closure, p > 0.3]. The PBRB was correlated to morphological abnormalities of (pre)proliferative retinopathy (1) intraretinal microvascular abnormalities (Sirma) and (2) new vessels (Sneo): pbrb = A – B.SIRMA – C.Sneo with PBRB in nm/sec, A = 1.5 ± 0.5, B = 0.9 ± 0.2 and C = 1.7 ± 0.4, R2 = 0.65, p < 0.0001]. It can be concluded that the increased blood retinal barrier permeability in diabetic patients is mainly due to (pre)proliferative abnormalities and not to non-proliferative abnormalities. |
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Keywords: | Diabetes mellitus diabetic retinopathy fluorescein fluorescein angiography fundus photography vitreous fluorophotometry |
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