In:
Acta Ophthalmologica, Wiley, Vol. 94, No. 6 ( 2016-09), p. 540-547
Abstract:
To investigate changes in retinal metabolism, function, structure and morphology in relation to initiation of insulin pump therapy (continuous subcutaneous insulin infusion, CSII ). Methods Visual acuity, retinopathy level, dark adaptation kinetics, retinal and subfoveal choroidal thickness, macular perfusion velocities, retinal vessel diameters and blood oxygen saturations were measured at baseline and after 1, 4, 16, 32 and 52 weeks in 31 patients with type 1 diabetes who started CSII and 20 patients who continued multiple daily insulin injections ( MDI ). Results One year of CSII reduced haemoglobin A 1c (HbA 1c ) by 1.6% (17.8 mmol/mol) compared with 0.3% (3.1 mmol/mol) in the MDI group (p 〈 0.0001). Central retinal thickness increased by 1.5% in the CSII group (within‐group p = 0.0098; between‐group p = 0.063) without producing macular oedema. No detectable change was found in any other primary outcome measure. The proportion of patients with retinopathy worsening did not differ between groups. At baseline, longer disease duration was associated with higher retinal artery oxygen saturation (p = 0.014) and lower macular venous perfusion velocity (p = 0.045). Conclusion One year of CSII led to an HbA 1c reduction relative to continued MDI and a small increase in retinal thickness but not to early retinopathy worsening or to changes in retinal vascular, structural or functional characteristics. Longer duration of type 1 diabetes appears to be associated with lower macular venous perfusion velocity and higher retinal artery oxygen saturation. The latter could potentially reflect cumulative glycaemia.
Type of Medium:
Online Resource
ISSN:
1755-375X
,
1755-3768
DOI:
10.1111/aos.2016.94.issue-6
Language:
English
Publisher:
Wiley
Publication Date:
2016
detail.hit.zdb_id:
2466981-7
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