The effect of strict glycmic control on retinal volumetric blood flow rate (Q) was investigated in 13 insulin-dependent diabetic patients with laser Doppler velocimetry and monochromatic fundus photography. Strict glycemic control was achieved by glucose monitoring and four daily insulin injections. Q was determined in a major retinal vein at baseline and then 5days, 2 mo, and 6 mo after the institution of strict control. Level of retinopathy was assessed from stereocolor fundus photographs taken at baseline and 6 mo. After 6 mo of strict diabetic control, five eyes demonstrated progression (P) by one or more retinopathy levels, and eight eyes showed no progression (NP). At 5 days, there was a significant decrease in Q of 1.4 ± 0.9 μU/min (P < 0.005) in NP eyes and a nonsignificant increase in Q of 1.2 ± 1.7 μU/min in P eyes. Changes in Q from baseline observed at 5 days were strongly correlated with changes in retinopathy level at 6 mo (r = 0.79, P <0.005). No significant changes in Q from baseline were observed at 2 and 6 mo. A lack of decrease in Q at 5 days was associated with the progression of retinopathy that occurs in some patients after the institution of strict glycemic control and may serve as a predictor for progression of retinopathy.
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Original Articles|
May 01 1990
Diabetic Glycemic Control and Retinal Blood Flow
Juan E Grunwald;
Juan E Grunwald
Department ot Ophthalmology, Scheie Eye Institute, and the Departments of Medicine and Pediatrics, School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania
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Alexander J Brucker;
Alexander J Brucker
Department ot Ophthalmology, Scheie Eye Institute, and the Departments of Medicine and Pediatrics, School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania
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Stanley S Schwartz;
Stanley S Schwartz
Department ot Ophthalmology, Scheie Eye Institute, and the Departments of Medicine and Pediatrics, School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania
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Seth N Braunstein;
Seth N Braunstein
Department ot Ophthalmology, Scheie Eye Institute, and the Departments of Medicine and Pediatrics, School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania
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Lester Baker;
Lester Baker
Department ot Ophthalmology, Scheie Eye Institute, and the Departments of Medicine and Pediatrics, School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania
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Benno L Petrig;
Benno L Petrig
Department ot Ophthalmology, Scheie Eye Institute, and the Departments of Medicine and Pediatrics, School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania
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Charles E Riva
Charles E Riva
Department ot Ophthalmology, Scheie Eye Institute, and the Departments of Medicine and Pediatrics, School of Medicine, University of Pennsylvania
Philadelphia, Pennsylvania
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Address correspondence and reprint requests to Dr. Juan E. Grunwald, Scheie Eye Institute, 51 North 39th Street, Philadelphia, PA 19104.
Diabetes 1990;39(5):602–607
Article history
Received:
September 18 1989
Revision Received:
January 04 1990
Accepted:
January 04 1990
PubMed:
2185110
Citation
Juan E Grunwald, Alexander J Brucker, Stanley S Schwartz, Seth N Braunstein, Lester Baker, Benno L Petrig, Charles E Riva; Diabetic Glycemic Control and Retinal Blood Flow. Diabetes 1 May 1990; 39 (5): 602–607. https://doi.org/10.2337/diab.39.5.602
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