Diabetes is the leading cause of eye disease in the UK, and increased plasma von Willebrand factor (vWf) marks endothelial damage and demonstrates a vascular cause.
However, the progression of the disease is variable and the ability to accurately detect those at greatest risk of serious ocular and cardiovascular disease is a much sought after clinical need, which can enable the most effective channelling of preventative resources.
Unfortunately, none of the standard methods of assessing eye vessels evaluates the function of the vessels in ‘real time’.
Researchers have recently developed and validated a new non-invasive method for assessing retinal vessel function that provides better information than a static view as offered by photography.
A normal retinal vessel responds to flickering light by dilating, and upon flicker cessation, returns to baseline over a short period of time. An abnormal response is a longer time needed to reach maximum vessel dilation and/ or a change in maximum dilation when a multiple stimulation protocol is applied, implying cause.
The aim of this study is to determine if the new and validated method of assessing vascular function of the retinal vessels is of sufficient sensitivity to differentiate those diabetics with and without coronary artery disease (CAD). This will provide a new non-invasive tool in the clinical management of diabetes.
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Publications
Heitmar, R, Varma, C, De, P, Lau, YC & Blann, AD 2016, 'The relationship of systemic markers of renal function and vascular function with retinal blood vessel responses' Graefe' s Archive for Clinical and Experimental Ophthalmology, vol. 254, no. 11, pp. 2257–2265. DOI:10.1007/s00417-016-3432-9
Heitmar, R, BLANN A. 2014, Retinal vessel oxygen saturation in diabetic patients with and without cardiovascular disease and its association with renal function. Acta Ophthalmologica, vol. 92, no. 0. doi:10.1111/j.1755-3768.2014.F046.x
Heitmar, R, Blann, A & Summers, AJ 2013, 'Retinal arteriolar diameter response to flicker light provocation - A useful marker for risk stratification in cardiovascular disease?' Acta Ophthalmologica, vol. 91, no. Suppl.s252, F059. DOI:10.1111/j.1755-3768.2013.F059.x -
Results
The findings of this study confirm previous results and hypothesis that measurements obtained by multiple stimulation require analysis of each stimulation cycle instead of an averaged approach as each patient group shows a different reaction pattern which gets lost in case of averaging. Different retinal reactivity pattern where found across the three tested patient groups (diabetic patients without cardiovascular disease, patients with cardiovascular disease only and those with a combination of both).
Researchers also found that renal function can alter retinal vessel parameters reactivity and hence recommend to factor this in for future research projects.