Aqueous humor endothelin-1 and total retinal blood flow in patients with non-proliferative diabetic retinopathy

作者：Khuu L A; Tayyari F; Sivak J M; Flanagan J G; Singer S; Brent M H; Huang D; Tan O; Hudson C^*

来源：Eye, 2017, 31(10): 1443-1450.

DOI：10.1038/eye.2017.74

Purpose The purpose of this study was to determine the association between aqueous ET-1 levels and total retinal blood flow (TRBF) in patients with non-insulindependent type 2 diabetes mellitus (T2DM) and early non-proliferative diabetic retinopathy (NPDR).
Patients and methods A total of 15 agematched controls and 15 T2DM patients with NPDR were recruited into the study. Aqueous humor (similar to 80-120 mu l) was collected before cataract surgery to measure the levels of ET-1 using suspension multiplex array technology. Four weeks post surgery, six images were acquired to assess TRBF using the prototype RTVue Doppler FD-OCT (Optovue, Inc., Fremont, CA, USA) with a double circular scan protocol. At the same visit, forearm blood was collected to determine plasma glycosylated hemoglobin (A1c) levels.
Results Aqueous ET-1 was significantly elevated in the NPDR group compared with the control group (3.5 +/- 1.8 vs 2.2 +/- 0.8, P= 0.02). TRBF was found to be significantly reduced in the NPDR group compared with the control group (34.5 +/- 9.1 vs 44.1 +/- 4.6 mu l/min, P=0.002). TRBF and aqueous ET-1 were not correlated within the NPDR group (r=-0.24, P=0.22). In a multivariate analysis, high A1c was associated with reduced TRBF and aqueous ET-1 levels across control and NPDR groups (P<0.01).
Conclusion Aqueous ET-1 levels were increased while TRBF was reduced in patients with NPDR compared with the control group. Although not directly associated, the vasoconstrictory effects of ET-1 are consistent with a reduced TRBF observed in early DR. ET-1 dysregulation may contribute to a reduction in retinal blood flow during early DR.

• 出版日期2017-10
• 单位河北医科大学