96th DOG Annual Meeting, 1998

P471

IS THERE AN ADDITIVE EFFECT OF AN ARTERIAL HYPERTENSION ON MACULAR CIRCULATION IN PATIENTS WITH DIABETES MELLITUS?

M. Rüffer, O. Arend, A. Remky, B. Bertram, B. Kirchhof

Fluorescein angiographic studies demonstrated alterations of macular microcirculation in patients with diabetes mellitus (Arend et al. 1991) and in patients with arterial hypertension (Wolf et al. 1994). Both diseases showed a reduced capillary blood velocity and decreased capillary density although more pronounced in diabetic patients. In this study we examined the influence of an arterial hypertension when associated with diabetes mellitus.

Patients: 62 patients with diabetes mellitus and arterial hypertension were compared with a matched diabetic population (match criteria: ETDRS stage of retinopathy). In all subjects fluorescein angiograms with the Scanning Laser Ophthalmoscope were performed and by means of digital image analysis macular capillary blood velocities (CBV), the perifoveal intercapillary area (PIA) and area of the foveal avascular zone (FAZ) were analyzed.

Results: Systolic and diastolic blood pressures were significantly increased in the population with associated arterial hypertension (BP syst: p=0.01; BP diast: p=0.003). Neither dynamic (CBV) nor morphologic measures (PIA, FAZ) showed significant differences among the examined populations.

Conclusion: The association of arterial hypertension and diabetes mellitus did not lead to more severe macular capillary alterations when compared with diabetic control subjects. This could be due to the fact that these patients were controlled and treated with antihypertensive medications (75%). Furthermore, epidemilogic studies (Moss et al. 1994) found no correlation of increased blood pressures with significant loss of visual acuity and Nergaardt et al. (1991) demonstrated that arterial hypertension is not per se asscociated with progressing diabetic retinopathy if not associated with a clinical apparent nephropathy.

Supported by Hochschulsonderprogramm III RWTH Aachen

Augenklinik der RWTH Aachen, Pauwelsstr. 30, 52057 Aachen


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