The longterm objective of this proposal is the continued investigation of macular retinal microvascular circulation in man using the noninvasive blue field simulation technique. Macular leukocyte flow and reactivity to breathing 100% oxygen will be examined in diabetic eyes as follows: la Eyes with varying types of diabetic maculopathy In a cross-sectional study of type one diabetics, leukocyte hemo- dynamics will be measured in diabetic eyes without microangiopathy and in eyes with specific maculopathy lesions. The results will be compared with measurements in eyes of age and sex matched normal individuals. Secondary objectives will be to investigate within the diabetic eyes with no microangiopathy, the effect on the microvascular circulation of (1) duration of diabetes, (2) blood glucose taken at the time of measurement, (3) glucose control as assessed by HgAlC and (4) peripheral leukocyte count. lb Eyes of patients after induction of acute hyperglycemia Alterations of macular retinal capillary blood flow and vascular reactivity will be examined in eyes of type one diabetic patients with mild diabetic retinopathy before and two hours following an oral glucose induction of hyperglycemia. lc Eyes undergoing macular focal argon photocoagulation for foveal edema and/or exudate. Macular leukocyte flow and microvascular hemodynamics will be measured in eyes before and following macular photocoagulation for diabetic macular edema and/or exudate to determine if changes occur and are associated with changes in the edema. These studies will provide new and unique information on the microvascular hemodynamic alterations which occur in the macula of diabetic eyes and should give insight into the mechanisms contributing to retinal vascular leakage, edema and exudate as well the effect of photocoagulation treatment. If changes are produced in the hemodynamics with acute elevation of blood sugar, this will provide significant insight into the mechanisms involved in development and progression of microangiopathy and will provide a potent tool to evaluate intervention.

Agency
National Institute of Health (NIH)
Institute
National Eye Institute (NEI)
Type
Research Project (R01)
Project #
5R01EY003388-10
Application #
3257727
Study Section
Visual Sciences A Study Section (VISA)
Project Start
1988-01-01
Project End
1991-06-30
Budget Start
1989-09-30
Budget End
1991-06-30
Support Year
10
Fiscal Year
1989
Total Cost
Indirect Cost
Name
Hahnemann University
Department
Type
Schools of Medicine
DUNS #
City
Philadelphia
State
PA
Country
United States
Zip Code
19129
Robinson, F; Chen, S; Petrig, B L et al. (1992) The acute effect of topical epinephrine on macular blood flow in humans. Invest Ophthalmol Vis Sci 33:18-22
Sinclair, S H (1991) Macular retinal capillary hemodynamics in diabetic patients. Ophthalmology 98:1580-6
Sinclair, S H; Azar-Cavanagh, M; Soper, K A et al. (1989) Investigation of the source of the blue field entoptic phenomenon. Invest Ophthalmol Vis Sci 30:668-73
Robinson, F; Petrig, B L; Sinclair, S H et al. (1985) Does topical phenylephrine, tropicamide, or proparacaine affect macular blood flow? Ophthalmology 92:1130-2
Robinson, F; Petrig, B L; Riva, C E (1985) The acute effect of cigarette smoking on macular capillary blood flow in humans. Invest Ophthalmol Vis Sci 26:609-13