Study: Ocular blood flow associated with coronary atherosclerosis in diabetes

In a study to evaluate the relationship between ocular blood flow, diabetic retinopathy and coronary artery disease in patients with diabetes, researchers found that ocular hemodynamic impairments within the eye are associated with atherogenic changes of coronary arteries.

Krasnicki and colleagues reported in the British Journal of Ophthalmology that they divided 56 participants into the following groups: 13 patients with diabetes and without coronary artery disease (CAD); 29 patients with diabetes and CAD; 20 patients without retinopathy; and nine patients with retinopathy.

The participants each provided their medical history and underwent an ophthalmic evaluation, including visual acuity, intraocular pressure, slit-lamp examination and direct and indirect ophthalmoscopy. Patients diagnosed with CAD were done so after a coronary angiogram. Researchers also used color Doppler imaging to assess end-diastolic and peak systolic blood velocities and resistivity indexes in the ophthalmic, central retinal and posterior ciliary arteries, as detailed in the study.

Results showed that patients with type 2 diabetes experienced blood flow disruptions within their ocular blood vessels due to the hardening of their coronary arteries, according to the study. They also suggested that diabetic retinopathy was associated with blood flow impairment within the central retinal artery in patients with both diabetes and CAD, but that disturbed blood flow in the ophthalmic and posterior ciliary arteries was not related to diabetic retinopathy.

"We propose that the changes in central retinal artery blood flow parameters in patients with type 2 diabetes can be explained by microvascular and macrovascular changes," the authors concluded. "There are few contradictory papers that address the issue of ocular hemodynamics in diabetic patients with and without CAD. The strengths of our study include standardized assessment of diabetic retinopathy and evaluation of atherogenic changes in the coronary arteries based on coronary angiogram. A better understanding of ocular hemodynamics may provide insight into the pathogenesis of ischemic, potentially devastating, ocular changes in patients with diabetes and CAD."