A diabeteses microangiopathia klinikai és laboratóriumi vizsgálata

Translated title of the contribution: Clinical and laboratory assessment of diabetic microvascular complications

G. M. Somfai, Salacz György, A. Somogyi

Research output: Contribution to journalArticle

Abstract

Aims: In developed countries, among them also in Hungary, the leading cause of legal blindness and visual impairment is diabetes. Optical coherence tomography (OCT) is an imaging method capable of near-histological resolution scanning of retinal tissue. The structural changes of the retina are caused by biochemical-physiological alterations, among which an increasing body of evidence is pointing towards the role of an enzyme, called semicarbazide- sensitive amine oxidase (SSAO). Methods: The relationship of macular volume and central foveal thickness with visual acuity was assessed in diabetic macular edema. We also investigated the risk factors for the occurrence of serous macular detachment (SMD). We investigated the sensitivity of the OCTRIMA (Optical Coherence Tomography Retinal IMage Analysis) software towards operator related image acquisition pitfalls (depolarization, defocusing, the combination of depolarization and defocusing and decentration of the scan). We assessed the activity of soluble SSAO, which is known to be correlated with the degree of retinopathy in humans, and examined its correlation to the tissue-bound aortic SSAO enzyme activity, chronic subclinical inflammation and oxidative stress in streptozotocin-induced male Whistar rats, treated under semi-intensive and intensive insulin regimes. Results: macular volume seems to be a more sensitive indicator of pathological changes in diabetes than central foveal thickness and macular volume and central foveal thickness are strongly correlated to visual acuity in diabetic macular edema. Eyes with serous macular detachment have better visual acuity compared to eyes with similar central foveal thickness and macular volume but without SMD. The risk of developing SMD may be higher in the presence of cystoid macular edema and long diabetes duration (longer than 15 years). OCT image segmentation by OCTRIMA was significantly influenced by the combined cases of decentration and depolarization. The activity of aortic tissue-bound and soluble SSAO were inversely related, poor glucose homeostasis increased the activity of soluble SSAO and also increased the level of C-reactive Protein (CRP, indicator of chronic subclinical inflammation) and oxidative stress (marked by a decreased Total Antioxidant Status, TAS). The levels of CRP, TAS and soluble SSAO activity were strongly correlated and their pathological changes were normalized only by intensive insulin treatment. Conclusions: Our results show the usefulness and importance of macular OCT examinations in early diabetes and also in diabetic maculopathy. Careful fine-tuning of imaging settings is important to obtain a best-possible scan in order to make reliable measurements with the use of the OCTRIMA software. Our results give indirect evidence for the source of soluble SSAO activity and emphasize the importance of tight glucose control in patients with diabetes.

Original languageHungarian
Pages (from-to)121-131
Number of pages11
JournalOrvoskepzes
Volume84
Issue numberSUPPL. 2
Publication statusPublished - 2009

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Amine Oxidase (Copper-Containing)
Diabetes Complications
Optical Coherence Tomography
Macular Edema
Visual Acuity
Oxidative Stress
Software
Antioxidants
Insulin
Inflammation
Glucose
Hungary
Vision Disorders
Enzymes
Blindness
Streptozocin
Developed Countries
C-Reactive Protein
Retina
Homeostasis

ASJC Scopus subject areas

  • Medicine(all)

Cite this

A diabeteses microangiopathia klinikai és laboratóriumi vizsgálata. / Somfai, G. M.; György, Salacz; Somogyi, A.

In: Orvoskepzes, Vol. 84, No. SUPPL. 2, 2009, p. 121-131.

Research output: Contribution to journalArticle

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abstract = "Aims: In developed countries, among them also in Hungary, the leading cause of legal blindness and visual impairment is diabetes. Optical coherence tomography (OCT) is an imaging method capable of near-histological resolution scanning of retinal tissue. The structural changes of the retina are caused by biochemical-physiological alterations, among which an increasing body of evidence is pointing towards the role of an enzyme, called semicarbazide- sensitive amine oxidase (SSAO). Methods: The relationship of macular volume and central foveal thickness with visual acuity was assessed in diabetic macular edema. We also investigated the risk factors for the occurrence of serous macular detachment (SMD). We investigated the sensitivity of the OCTRIMA (Optical Coherence Tomography Retinal IMage Analysis) software towards operator related image acquisition pitfalls (depolarization, defocusing, the combination of depolarization and defocusing and decentration of the scan). We assessed the activity of soluble SSAO, which is known to be correlated with the degree of retinopathy in humans, and examined its correlation to the tissue-bound aortic SSAO enzyme activity, chronic subclinical inflammation and oxidative stress in streptozotocin-induced male Whistar rats, treated under semi-intensive and intensive insulin regimes. Results: macular volume seems to be a more sensitive indicator of pathological changes in diabetes than central foveal thickness and macular volume and central foveal thickness are strongly correlated to visual acuity in diabetic macular edema. Eyes with serous macular detachment have better visual acuity compared to eyes with similar central foveal thickness and macular volume but without SMD. The risk of developing SMD may be higher in the presence of cystoid macular edema and long diabetes duration (longer than 15 years). OCT image segmentation by OCTRIMA was significantly influenced by the combined cases of decentration and depolarization. The activity of aortic tissue-bound and soluble SSAO were inversely related, poor glucose homeostasis increased the activity of soluble SSAO and also increased the level of C-reactive Protein (CRP, indicator of chronic subclinical inflammation) and oxidative stress (marked by a decreased Total Antioxidant Status, TAS). The levels of CRP, TAS and soluble SSAO activity were strongly correlated and their pathological changes were normalized only by intensive insulin treatment. Conclusions: Our results show the usefulness and importance of macular OCT examinations in early diabetes and also in diabetic maculopathy. Careful fine-tuning of imaging settings is important to obtain a best-possible scan in order to make reliable measurements with the use of the OCTRIMA software. Our results give indirect evidence for the source of soluble SSAO activity and emphasize the importance of tight glucose control in patients with diabetes.",
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