EARLY CHANGES IN DIABETIC-RETINOPATHY - CAPILLARY LOSS AND BLOOD-RETINA BARRIER PERMEABILITY IN RELATION TO METABOLIC CONTROL

In diabetic retinopathy capillary loss and blood-retina barrier leakag e are prominent factors. We present a study with quantitative measurem ents of both capillary loss and leakage and their relation to cumulati ve metabolic control. Seventeen insulin-dependent diabetic patients wi th no retinopathy or only mild background retinopathy and 10 years' du ration of the disease were included in the study. Status of metabolic regulation had been followed for at least 6 years. Seven healthy subje cts were included as controls. In diabetic patients the perifoveal int ervascular areas were found to increase significantly with the cumulat ive HbA1c index (p = 0.02) and in relation to the presence of moderate background retinopathy (p < 0.02). The blood-retina barrier leakage a nd the area of the foveal avascular zone were not significantly differ ent from healthy subjects and no correlation was found between the HbA 1c index and blood-retina barrier permeability. We conclude that perif oveal capillary loss occurs early in the course of diabetic retinopath y and that this loss is related to prior glycemic control and to the o phthalmoscopic retinopathy level.