Br J Ophthalmol 1997;81:274-278 ( April )
Retinal vessel dilatation and elongation precedes diabetic
macular oedema
Jóhannes Kári Kristinsson,
María Soffía Gottfredsdóttir,
Einar Stefánsson
Department of
Ophthalmology, University of Iceland, Landakotsspítali, Reykjavík,
Iceland
Correspondence to: Einar
Stefánsson, MD, PhD, University of Iceland, Department of
Ophthalmology, Öldugata 17, IS 101 Reykjavík, Iceland.
Accepted for publication 25 November 1996
AIMS/BACKGROUND Retinal vessel dilatation is a
well known phenomenon in diabetes. In this study, the theory of whether
excessive changes in diameter and length of retinal vessels occur in
the development of diabetic macular oedema was tested, supporting a
hypothesis that the development of diabetic macular oedema may be
linked to hydrostatic pressure changes described in Starling's law.
METHODSFrom fundus photographs of diabetic
patients attending a regular eye screening programme, the diameter and
segment length of retinal vessels were measured in three retinopathy
groups (12 patients each) with diabetic macular oedema (DMO),
background retinopathy and no retinopathy, over a period of
approximately 4 years, ending at the time of diagnosis of diabetic
macular oedema in the DMO group.
RESULTSA statistically significant dilatation and
elongation of retinal arterioles, venules, and their macular branches
was found before the diagnosis of macular oedema in the DMO group. No
significant changes were found in the other two groups.
CONCLUSIONIt is suggested that Starling's law
applies to the formation of oedema in the retina as in other tissues.
© 1997 by British Journal of Ophthalmology
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