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Abnormal retinal artery responses to stress in patients with type I diabetes.

The brachial artery pressure and retinal artery pressure responses to a one-minute cold pressor test were evaluated simultaneously in 14 patients with type I diabetes mellitus (six with and eight without diabetic retinopathy) and 10 age-matched control subjects. Five patients with type I diabetes had autonomic neuropathy. Mean baseline brachial artery pressure and retinal artery pressure were similar in patients with type I diabetes and control subjects. After cold pressor testing, the brachial artery pressure increased significantly (p less than 0.01) compared with baseline values in both groups. Retinal mean arterial pressures increased significantly (p less than 0.001) after cold pressor testing compared with the baseline values only in patients with type I diabetes. Positive correlation was found between the brachial and retinal mean arterial pressures after cold pressor testing (r = 0.48; p less than 0.05) in the diabetic patients but not in the control subjects (r = 0.10; p = NS). No correlation was found between the retinal artery pressure and age of onset of diabetes, duration of diabetes, the presence or absence of diabetic retinopathy, and glycemic control. Four patients with autonomic neuropathy and low retinal artery pressures, which remained unchanged after cold pressor testing, had no diabetic retinopathy. The fifth patient with autonomic neuropathy and exaggerated systolic brachial artery pressure (175 mm Hg) and retinal artery pressure (more than 80 mm Hg) responses had severe background diabetic retinopathy. In conclusion, abnormal retinal artery responses to stress are present in patients with type I diabetes. This may be modified by the presence or absence of both autonomic neuropathy and hypertension. The biologic significance of these findings is yet to be determined.

Adult↗

Comparative evaluation of current ophthalmodynamometers.

Seventy-five patients under 40 years of age with no history of ocular, cardiovascular, or cerebrovascular disease were examined with four commonly used ophthalmodynamometers. There was a significant difference in the absolute values measured with each instrument and the ophthalmic to brachial artery pressure ratio. The standard deviations were comparable between 8.1 and 10.2%. The absolute value of the average percent difference between the right and the left eye ranged from 3.6% with the Galin unit to 6.7% with the Sisler unit. Limits of +/- 15% for ophthalmic artery to brachial artery pressure ratio and 10% for right to left pressure difference should be used for 95% confidence levels. There was a small but definite correlation between the ocular coefficient of rigidity and pressure differences between direct and indirect instruments.

Adolescent↗