Vascular And Diabetic Eye Disease 2 Saturday 19 May 11:00 - 12:30 Salle Camille Blanc
T. Rotsos, J. Lekakis, A. Protogerou, M. Mavrikakis,
GREECE
ACE inhibitors and endothelial dysfunction in patients with diabetic retinopathy
Purpose: The objective of the present study is to examine the effect on the endothelial function after oral administration of angiotensin converting enzyme inhibitors in patients with diabetic retinopathy and to examine the correlation between the endothelial function and the type of diabetic retinopathy in patients with diabetes mellitus type II. Setting: Forty three consecutive patients with type II diabetes mellitus and diabetic retinopathy were blindly randomized in three groups receiving orally either quinapril or captopril or placebo. 23 patients (53.48%) were suffering from proliferative diabetic retinopathy (PDR) and 20(46.51%) from background retinopathy(BDR). Forearm blood flow (FBF) was studied using venous occlusion plethysmography (Hokason DE, model E20). All subjects underwent measurement of FBF at baseline and Reactive Hyperemia (RH) (phase A). FBF during reactive hyperemia was measured every 15 seconds for 3 minutes. Subsequently, patients received either 20mg quinapril or 25mg captopril or placebo. FBF measurements at baseline and during RH were repeated two hours later (phase B). We also calculated for each patient the maximal percentage change of flow and the duration of RH prior and after the administration of the regimen. Results: Maximal percentage change of flow was significantly higher (133,26 +58,68 % vs 75,10 +31,23 %, p=0,006) in patients with PDR and administration of quinapril. Administration of quinapril increased significantly the duration of RH (45 +21,21 vs 26,25 +10,61, seconds, p=0,02) in patients with PDR. Forearm blood flow was boundary statistically significantly higher in patients with BDR to patients with PDR (5,71+2.56 vs 5,19+1.37, ml/min/100cc tissue ,p=0.05). Hyperaemic blood flow was statistically significantly higher in patients with BDR compare to patients with PDR (11.61 + 5.53 vs 9.68 + 3.18 ,ml/min/100cc tissue,p=0.03). Conclusions: The acute administration of quinapril (high affinity to tissue ACE) improved the endothelial function in patients with PDR and diabetes mellitus type II. Administration of qiunapril had no effect on the endothelial function in patients with BDR. Patients with BDR had better endothelial function compare to patients with PDR.
