Skip to main content

Advertisement

Log in

Circulatory parameters in the retrobulbar central retinal artery and vein of patients with diabetes and medically treated systemic hypertension

  • Retinal Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Background

We aim to study the circulatory parameters in the retrobulbar central retinal artery and vein in diabetic patients with and without medically treated systemic hypertension.

Methods

The study included 108 patients with diabetes that were allocated in four different groups according to the presence of diabetic retinopathy (DR) and hypertension: group 1—patients without DR and without hypertension (n = 23), group 2—patients without DR and with hypertension (n = 21), group 3—patients with nonproliferative DR and without hypertension (n = 36), group 4—patients with nonproliferative DR and with hypertension (n = 28). The circulatory parameters that were evaluated were: peak systolic blood velocity (PSV), end-diastolic blood velocity (EDV), maximum venous velocity (Vmax), minimum venous velocity (Vmin) and the Pourcelot index which were measured using color Doppler imaging. Non-parametric tests were used to test inter-group differences. Spearman’s coefficient of correlation was tested between ocular perfusion pressure and the circulatory parameters in each of the patient groups. Contingency table was performed to test the relation of diabetic retinopathy and hypertension to the PSV in the central retinal artery.

Results

The PSV and EDV in the central retinal artery was significantly higher in group 1 (p = 0.02, p = 0.04) and group 2 (p = 0.02, p = 0.02) than in group 3. The Pourcelot index in the central retinal vein was significantly lower in group 1 than in group 4 (p = 0.02), and in group 2 than in groups 3 and 4 (p = 0.02, p < 0.01). A significant relationship was detected between the presence of hypertension, the stage of diabetic retinopathy and the PSV in the central retinal artery of our patients (χ2 = 8.29; p = 0.04).

Conclusion

Medically treated hypertension affects the retrobulbar circulatory parameters in the central retinal artery and vein in diabetes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Gillow JT, Gibson JM, Dodson PM (1999) Hypertension and diabetic retinopathy-what’s the story? Br J Ophthalmol 83:1083–1087

    Article  PubMed  CAS  Google Scholar 

  2. United Kingdom Prospective Diabetes Study Group (1998) Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes. UKPDS report 38. BMJ 317:703–713

    Google Scholar 

  3. Kim SK, Christlieb R, Mieler WF, Jakobiec FA (2000) Hypertension and its ocular manifestations. In: Albert DM, Jakobiec FA (eds) Principles and practice of ophthalmology. 2nd edn. WB Saunders, Philadelphia, pp 4506–4524

    Google Scholar 

  4. Esgin H, Alimgil L, Erda S (2001) The effect of systemic hypertension on pulsatile ocular blood flow in diabetic patients. Acta Ophthalmol Scand 79:160–162

    Article  PubMed  CAS  Google Scholar 

  5. Arend O, Ruffer M, Remky A (2000) Macular circulation in patients with diabetes mellitus with and without arterial hypertension. Br J Ophthalmol 84:1392–1396

    Article  PubMed  CAS  Google Scholar 

  6. Patel V, Rassam SMB, Chen HC et al (1994) Oxygen reactivity in diabetes mellitus: effect of hypertension and hyperglycaemia. Clin Sci 86:689–695

    PubMed  CAS  Google Scholar 

  7. Ahmetoglu A, Erdol H, Simsek A et al (2003) Effect of hypertension and candesartan on the blood flow velocity of the extraocular blood vessels in hypertensive patients. Eur J Ultrasound 16(3):177–182

    Article  PubMed  Google Scholar 

  8. Steigerwalt RD Jr, Belcaro GV, Laurora G, Cesarone MR, De Sanctis MT, Incandela L (1998) Ocular and orbital blood flow in patients with essential hypertension treated with trandolapril. Retina 18(6):539–545

    Article  PubMed  Google Scholar 

  9. Fukuda M (1994) Classification and treatment of diabetic retinopathy. Diabetes Res Clin Pract 24(Suppl):S171–S176

    Article  PubMed  Google Scholar 

  10. Dimitrova G, Kato S, Tamaki Y et al (2001) Choroidal circulation in diabetic patients. Eye 15:602–607

    PubMed  CAS  Google Scholar 

  11. Ulbig MW, Hoops JP (2000) Epidemiology of diabetic retinopathy. In: van Bijsterveld OP (ed) Diabetic retinopathy. 1st edn. Martin Dunitz, London, pp 143–154

    Google Scholar 

  12. Zander E, Herfurth S, Bohl B et al (2000) Maculopathy in patients with diabetes mellitus type 1 and type 2: associations with risk factors. Br J Ophthalmol 84:871–976

    Article  PubMed  CAS  Google Scholar 

  13. Hsueh WA, Anderson PW (1992) Hypertension, the endothelial cell, and the vascular complications of diabetes mellitus. Hypertension 20:253–263

    PubMed  CAS  Google Scholar 

  14. Guven D, Ozdemir H, Hasanreisoglu B (1996) Hemodynamic alterations in diabetic retinopathy. Ophthalmology 103:1245–1249

    PubMed  CAS  Google Scholar 

  15. Rassam SMB, Patel V, Kohner EM (1995) The effect of experimental hypertension on retinal vascular autoregulation in humans: a mechanism for the progression of diabetic retinopathy. Exp Physiol 80:53–68

    PubMed  CAS  Google Scholar 

  16. Dimitrova G, Kato S, Yamashita H et al (2003) Relation between retrobulbar circulation and progression of diabetic retinopathy. Br J Ophthalmol 87:622–625

    Article  PubMed  CAS  Google Scholar 

  17. Wolf S, Arend O, Schulte K, Ittel TH, Reim M (1994) Quantification of retinal capillary density and flow velocity in patients with essential hypertension. Hypertension 23(4):464–467

    PubMed  CAS  Google Scholar 

  18. Pache M, Kube T, Wolf S, Kutschbach P (2002) Do angiographic data support a detailed classification of hypertensive fundus changes? J Hum Hypertens 16(6):405–410

    Article  PubMed  CAS  Google Scholar 

  19. Niknam RM, Schocket LS, Metelitsina T, DuPont JC, Grunwald JE (2004) Effect of hypertension on foveolar choroidal haemodynamics. Br J Ophthalmol 88(10):1263–1265

    Article  PubMed  CAS  Google Scholar 

  20. Clermont A, Bursell SE, Feener EP (2006) Role of the angiotensine II type 1 receptor in the pathogenesis of diabetic retinopathy: effects of blood pressure control and beyond. J Hypertens 24:S73–S80

    Article  CAS  Google Scholar 

  21. Williamson TH (2007) A “throttle” mechanism in the central retinal vein in the region of the lamina cribrosa. Br J Ophthalmol 91(9):1190–1193

    Article  PubMed  Google Scholar 

Download references

Acknowledgement

The statistical analysis was supervised by Associate Professor Vladimir Nikolov, (Department of Biostatistics, Clinical Center, Skopje, Republic of Macedonia).

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Galina Dimitrova.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dimitrova, G., Kato, S., Fukushima, H. et al. Circulatory parameters in the retrobulbar central retinal artery and vein of patients with diabetes and medically treated systemic hypertension. Graefes Arch Clin Exp Ophthalmol 247, 53–58 (2009). https://doi.org/10.1007/s00417-008-0925-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-008-0925-1

Keywords

Navigation