Macular circulation in patients with diabetes mellitus with and without arterial hypertension

Background-Previous fluorescein angiographic studies have shown alterations in the macular microcirculation in patients with diabetes mellitus and art erial hypertension. In both diseases capillary blood velocity was reduced a nd capillary density decreased. These changes were more pronounced in diabe tic patients. We have examined the influence of arterial hypertension in co mbination with diabetes mellitus. Methods-62 patients with diabetes mellitus and arterial hypertension (group 1) were matched with patients with diabetes mellitus but without arterial hypertension (group 2, match criteria: ETDRS stage of retinopathy). In all subjects fluorescein angiograms were performed with a scanning laser ophtha lmoscope. Macular capillary blood velocity (CBV), perifoveal intercapillary area (PIA), the coefficient of variation of both parameters, the area of t he foveal avascular zone (FAZ), and the arteriovenous passage time (AVP) we re assessed by digital image analysis. Results-Systolic and diastolic blood pressures were significantly increased in the patients with arterial hypertension (systolic p=0.0008; diastolic p =0.03). Neither dynamic measures (AVP: 1.64 (0.49) seconds (group 1), 1.72 (0.58) seconds (group 2); CBV: 1.98 (0.39) mm/s (group 1), 2.09 (0.43) mm/s (group 2)) nor morphological measures (PLA: 7985 (3137) mum(2) (group 1), 8338 (3376) mum(2) (group 2); FAZ: 0.319 (0.206) mm(2) (group 1), 0.363 (0. 237) mm(2) (group 2)) were significantly different between the two groups o f diabetic patients. Conclusion-Arterial hypertension did not result in more severe macular capi llary dropout than diabetes without hypertension. This might be explained b y the fact that most of the patients were being treated with antihypertensi ve drugs.