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Year : 1982  |  Volume : 30  |  Issue : 6  |  Page : 603-604

The role of rheological and related factors in diabetic retinopathy

Dept. of Ophthalmology, S.M.S. Medical College, Jaipur, India

Correspondence Address:
O P Kulshrestha
Upgraded Department of Ophthalmology, S.M.S. Medical College, Jaipur
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Source of Support: None, Conflict of Interest: None

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How to cite this article:
Kulshrestha O P, Mathur M, Mathur P K. The role of rheological and related factors in diabetic retinopathy. Indian J Ophthalmol 1982;30:603-4

How to cite this URL:
Kulshrestha O P, Mathur M, Mathur P K. The role of rheological and related factors in diabetic retinopathy. Indian J Ophthalmol [serial online] 1982 [cited 2023 Dec 2];30:603-4. Available from: https://journals.lww.com/ijo/pages/default.aspx/text.asp?1982/30/6/603/29295

Table 2

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Table 2

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Table 1

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Table 1

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The basic pathology behind the production of diabetic retinopathy is obstruction to micro­circulation in the retina producing hypoxia and secondlry production of neovascularisation, microaneurysms and haemorrhages. The obstruction is thought to be related to certain changes occuring in the blood i.e. the Rheological factors. These so called rheological factors include plasma protein fractions like albumin, Alpha-2 globulin and fibrinogen, erythrocyte and platelet aggregation and viscosity "of blood. Changes caused by these factors produce increased tendency of red blood cells and platelets to aggregate, increa­sing plasma viscosity and impairing the blood flow in the microcirculation with resulting hypoxia.

  Method material observation and discussion Top

The present study included 40 diabetic patients and 10 normal healthy individuals to serve as controls. They were divided into 3 groups.

Group I : Non Diabetic healthy indivi­duals- 10 cases

Group II : Diabetic patients without reti­nopathy-IO cases.

Group III A : Diabetic patients with simple retinopathy-20 cases.

Group III B : Diabetic patients with pro­liferative retinopathy­ 10 cases.

There was a significant fall in the average plasma levels of albumin in diabetics with retinopathy as compared to normal indivi­duals. Albumin levels was 4.0 gms% in norma 1 healthy individuals (group I), 2.6 gms% in diabetics without retinopathy (Group II), 2.05 gm% in diabetics with simple retino­pathy (Group III A) and 1.54 gm% in diabetics with proliferative retinopathy (Group III B).

There was progressive increase in level of Alpha-2 Globulin from healthy individual towards diabetics. The average for group I was 0.6 gm%, for group II 0.8 gm%, for group III A 1.0 gm% and for group III B 1.2 gm%, Albumin and globulin estimations were done by paper electrophoresis technique using Beckman Model "R" paper electro­phoresis system.

In a similar way plasma Fibrinogen levels were affected to a much larger extent. The serum fibrinogen level was 223 mg% in normal individuals (I), 370 mg% in diabetic (II), 490 mg% in diabetics with simple retinopathy (III A) and 527 mg% in diabetics with; proli­ferative retinopathy. Fibrinogen is also one of the plasma proteins and estimation was done by modified technique of Kings.

An increase in the mean value of plasma viscosity was noted in diabetics and much more so in diabetics with retinopathy. The average plasma viscosity levels were Group I 1.60 opo, Group 11 1.86 cpo, Group 11I A 2.09 cpo and group III B 2.25 cpo. Taking the average for all cases with retinopathy. [Table - 1] (III A & III B) as 2.16 cpo, the serum viscosity increased by an average of 35% in these cases as compared to normal non-diabetic individuals. Viscosity measurement was done by modified ostwald capillary tube viscometer because it requires only 2.5 ml. of plasma and it was easy to wash [Table - 2]. The platelets and erythrocytes also showed an increased tendency to aggre­gate in diabetics with retinopathy. The mean value of platelet aggregation index in different groups I 0.43 O.D., Group II o.53 O.D., Group III A 0.68 O.D. and Group III B 0.85 O. D.

Mean value of red cell aggregation (as indirectly evidenced by erythrocyte Sedimen­tation rate) was group 1 12 mm./1st hour, Group 11 32 mm./ 1st hour, Group II I A 42 mm Ist hour and Group III B 46 mm./1st hour. This was statistically significant.

  Summary Top

Blood studies were done in 40 diabetics and 10 normal subjects and estimations done for albumin, alpha-2 globulin fibrinogen, plasma viscosity, platelet aggregations and erythrocyte aggregations. There was reduction in plasma albumin in diabetics with retinopathy but in­crease in all other values as compared to normal individuals.

The probable role of these rheological factors is also discussed.


  [Table - 1], [Table - 2]


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