RESUMO
AIMS: To investigate changes in retinal vessel diameter during acute hyperglycemia in patients with type 1 diabetes. METHODS: We conducted a study on 11 subjects with type 1 diabetes. Euglycemia was maintained for 3h followed by induction of hyperglycemia and simultaneous bolus of rapid acting insulin. Two fundus photos were captured during euglycemia and five fundus photos, blood glucose and blood pressure were taken every 30min for 2.5h post-prandial. Central retinal artery equivalent (CRAE) and central retinal vein equivalent (CRVE) were measured over the study visit and examined using generalized linear mixed models. RESULTS: In a multivariate mixed model, mean CRAE and CRVE were reduced at 90min post-prandial in both zones B and C. In repeated measures analysis, arterioles exhibited a significant association with change in vessel caliber per change in blood glucose. Inconsistent effects of blood pressure on vessel diameter were also measured. CONCLUSIONS: We document a change in retinal vessel diameter during acute hyperglycemia in persons with type 1 diabetes. Larger controlled studies are required to further investigate this phenomenon and to more accurately assess if hyperglycemia has direct effects on retinal vessel diameter.
Assuntos
Diabetes Mellitus Tipo 1/patologia , Retinopatia Diabética/patologia , Hiperglicemia/patologia , Vasos Retinianos/patologia , Doença Aguda , Adolescente , Adulto , Pressão Sanguínea/efeitos dos fármacos , Pressão Sanguínea/fisiologia , Diabetes Mellitus Tipo 1/complicações , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/fisiopatologia , Retinopatia Diabética/diagnóstico , Retinopatia Diabética/etiologia , Retinopatia Diabética/fisiopatologia , Feminino , Fundo de Olho , Glucose/administração & dosagem , Glucose/farmacologia , Humanos , Hiperglicemia/induzido quimicamente , Hiperglicemia/etiologia , Insulina/administração & dosagem , Insulina/farmacologia , Masculino , Pessoa de Meia-Idade , Tamanho do Órgão , Fotografação , Projetos Piloto , Artéria Retiniana/diagnóstico por imagem , Artéria Retiniana/patologia , Veia Retiniana/diagnóstico por imagem , Veia Retiniana/patologia , Vasos Retinianos/diagnóstico por imagem , Vasos Retinianos/efeitos dos fármacos , Vasodilatação/efeitos dos fármacos , Adulto JovemRESUMO
Wolfram Syndrome (WS) is a rare, autosomal recessive disorder that causes non-autoimmune type 1 diabetes. The etiology involves a single gene mutation of the wolframin protein inducing endoplasmic reticulum stress and apoptosis in selected cell types with resultant diabetes insipidus, diabetes mellitus, optic atrophy, and sensory-neural deafness. Symptoms are initially absent and signs within the posterior segment of the eye are usually the earliest indicator of WS.These cases characterize unusual and poorly described findings of pigmentary maculopathy in WS and illustrate the importance of collaboration between diabetes and eye care providers; especially in cases of non-autoimmune type 1 diabetes exhibiting atypical human leukocyte-associated antigen haplotypes.
