Abstract
The retinal vessel calibre responses to systemic sympathetic stimulation, were studied in 22 randomly selected diabetic patients (mean age ± SEM: 54.7 ± 2.59 years, range 25-73; 13 IDDM, 9 NIDDM; 4 females), using sustained isometric muscle contraction as the stimulus. At a different session the integrity of the autonomic nerve function in these diabetic patients was assessed using 3 standard tests of autonomic nerve function, based on cardiovascular reflexes. Diabetic patients with an intact autonomic nervous system: Group 1, (n=11, mean age: 54.9 ± 4.55 years, 7 IDDM 4 NIDDM) showed a mean arteriolar constriction of 9.2% (SEM 2.89, p<0.01) and a mean venule constriction of 5.1% (SEM 1.73, p<0.02), for a mean rise in diastolic blood pressure of 23.7 mmHg (SEM 2.19 range: 13-33). There were no significant mean retinal vessel responses however, in diabetics with autonomic dysfunction (Group 2): mean arteriolar constriction of 1.2% (SEM 1.38 p>0.05) and venule constriction of 2.1% (SEM 1.38, p>0.05); for a mean rise in diastolic blood pressure of 19.8 mmHg (SEM 4.49, range: 2-50). There was no correlation between the rise in diastolic blood pressure and the retinal arteriolar constriction in the 2 groups (Group 1: r=0.45, p>0.1 and Group 2: r=0.56, p>0.05). Duration, type and control of diabetes were not significantly different between the 2 groups. The severity of retinopathy was slightly worse in Group 2 compared to Group 1. These results point to an association between autonomic neuropathy and failure of regulation of retinal blood flow.
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Lanigan, L., Clark, C., Allawi, J. et al. Responses of the retinal circulation to systemic autonomic stimulation in diabetes mellitus. Eye 3, 39–47 (1989). https://doi.org/10.1038/eye.1989.6
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DOI: https://doi.org/10.1038/eye.1989.6
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