Mandecka Aleksandra, Dawczynski Jens, Vilser Walthard, Blum Marcus, Müller Nicolle, Kloos Christoph, Wolf Gunter, Müller Ulrich Alfons
Department of Internal Medicine III, Friedrich- Schiller University, Jena, Germany.
Diabetes Res Clin Pract. 2009 Oct;86(1):51-5. doi: 10.1016/j.diabres.2009.06.017. Epub 2009 Jul 30.
Investigation of retinal vasodilation under flickering light is considered a dynamic analysis in contrast to the static analysis of retinal vessel equivalents (mean retinal vessel diameter). We investigated whether dynamic analysis apart from the static one in type 1 diabetic patients without diabetic retinopathy with well-controlled diabetes could lead to additional information regarding retinal autoregulation.
18 normotensive type 1 diabetic patients without retinopathy and 19 healthy subjects were included. Diameter of retinal vessels was measured with Dynamic Vessel Analyzer. Changes in vasodilation are expressed as percent change over baseline values.
HbA(1c) was 7.5+/-1.0% in diabetic patients. In arteries, the response to flicker was diminished in diabetic patients compared to healthy volunteers (p<0.023). In patients flicker stimulation increased arterial diameter by +2.7% in contrast to +4.4% in controls. Venous vessel diameter increased by +3.1% in diabetic individuals and by +5.3% in the control group (p<0.002). There were no differences in static analysis between both groups.
Diabetic patients without retinopathy with relatively good glycemic control show reduced retinal vasodilation after flicker indicating dysfunction in retinal autoregulation. The use of provocation test in conjunction with static analysis could lead to additional information regarding abnormal retinal autoregulation.
与视网膜血管等效物（平均视网膜血管直径）的静态分析相比，闪烁光下视网膜血管舒张的研究被视为一种动态分析。我们研究了在糖尿病控制良好的1型糖尿病无糖尿病视网膜病变患者中，除静态分析外的动态分析是否能提供有关视网膜自动调节的额外信息。
纳入18例血压正常的无视网膜病变的1型糖尿病患者和19名健康受试者。使用动态血管分析仪测量视网膜血管直径。血管舒张的变化以相对于基线值的百分比变化表示。
糖尿病患者的糖化血红蛋白（HbA1c）为7.5±1.0%。在动脉中，与健康志愿者相比，糖尿病患者对闪烁的反应减弱（p<0.023）。在患者中，闪烁刺激使动脉直径增加了2.7%，而对照组为4.4%。糖尿病个体的静脉血管直径增加了3.1%，对照组增加了5.3%（p<0.002）。两组之间的静态分析没有差异。
血糖控制相对良好的无视网膜病变的糖尿病患者在闪烁后视网膜血管舒张减少，表明视网膜自动调节功能障碍。激发试验与静态分析结合使用可能会提供有关视网膜自动调节异常的额外信息。
