Laurence S Lim1, Lieng H Ling2, Peng Guan Ong3, Wallace Foulds3, E Shyong Tai4, Edmund Wong3, Shu Yen Lee3, Doric Wong3, Chui Ming Gemmy Cheung1, Tien Yin Wong1. 1. Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Graduate Medical School, Singapore Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. 2. Cardiac Department, National University Heart Centre, Singapore Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore. 3. Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Graduate Medical School, Singapore. 4. Singapore Eye Research Institute, Singapore National Eye Centre, Duke-NUS Graduate Medical School, Singapore Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Abstract
PURPOSE: This study investigated the responses of retinal vessels to flickering light in diabetic patients with various stages of diabetic retinopathy (DR). METHODS: This cross-sectional observational study evaluated adult subjects with diabetes mellitus. The Dynamic Vessel Analyzer (DVA) was used to measure retinal vascular dilatation in response to diffuse illuminance flicker. Diabetic retinopathy was graded from retinal photography. RESULTS: There were 279 subjects in total, with a mean age of 59.9 ± 9.2 years. The majority were male (73%) and the mean HbA1c level and mean duration of diabetes were 7.7% ± 1.4% and 13.9 ± 10.4 years, respectively. After adjustments for age, sex, smoking, duration of diabetes, HbA1c, hypertension, and hyperlipidemia, the responses of both retinal arterioles and venules to flicker stimulation decreased continuously with increasing stages of diabetic retinopathy (P = 0.008 and <0.001, respectively). Subjects with reduced arteriolar dilation responses were more likely to have any DR (odds ratio, OR, 1.20, [95% confidence interval (CI), 1.01-1.45], P = 0.045, per SD decrease). Subjects with reduced venular dilation responses were more likely to have any DR, moderate DR, or vision-threatening DR (OR: 1.27 [1.04-1.53], P = 0.02; OR: 1.27 (1.06-1.49), P = 0.007; and OR: 1.51 (1.14-1.50), P = 0.002; per SD decrease, respectively). CONCLUSIONS: The responses of retinal arterioles and venules to flickering light are reduced in subjects with DR, and decrease progressively with more severe stages of DR. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.
PURPOSE: This study investigated the responses of retinal vessels to flickering light in diabeticpatients with various stages of diabetic retinopathy (DR). METHODS: This cross-sectional observational study evaluated adult subjects with diabetes mellitus. The Dynamic Vessel Analyzer (DVA) was used to measure retinal vascular dilatation in response to diffuse illuminance flicker. Diabetic retinopathy was graded from retinal photography. RESULTS: There were 279 subjects in total, with a mean age of 59.9 ± 9.2 years. The majority were male (73%) and the mean HbA1c level and mean duration of diabetes were 7.7% ± 1.4% and 13.9 ± 10.4 years, respectively. After adjustments for age, sex, smoking, duration of diabetes, HbA1c, hypertension, and hyperlipidemia, the responses of both retinal arterioles and venules to flicker stimulation decreased continuously with increasing stages of diabetic retinopathy (P = 0.008 and <0.001, respectively). Subjects with reduced arteriolar dilation responses were more likely to have any DR (odds ratio, OR, 1.20, [95% confidence interval (CI), 1.01-1.45], P = 0.045, per SD decrease). Subjects with reduced venular dilation responses were more likely to have any DR, moderate DR, or vision-threatening DR (OR: 1.27 [1.04-1.53], P = 0.02; OR: 1.27 (1.06-1.49), P = 0.007; and OR: 1.51 (1.14-1.50), P = 0.002; per SD decrease, respectively). CONCLUSIONS: The responses of retinal arterioles and venules to flickering light are reduced in subjects with DR, and decrease progressively with more severe stages of DR. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.
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