Retinal fluorescein angiography (FA), an exam that evaluates retinal perfusion, may detect preclinical diabetic retinopathy, such as retinal vessel permeability changes, microvascular leakage and blood-retina barrier breakdown. It is a general consensus that DR should be annually screened if the fundus is normal. These chronic diabetes complications may not arise simultaneously in Type 1 diabetes (T1DM) patients, but this heterogeneity might be due to inaccurate diagnosis. DR and diabetic nephropathy are microvascular complications of diabetes mellitus (DM) which share some similar risk factors and pathophysiology pathways, such as increased vascular permeability. These findings point to a homogenous presentation of the diabetic microangiopathies.ĭiabetic retinopathy (DR) is the leading cause of visual impairment in developed countries visual acuity usually declines because of macular edema or retinal ischemia. Retinal changes may be found with more sensitive testing in these patients, especially with impaired estimated glomerular filtration rate, even if the fundus exam is normal, and fluorescein angiography should be considered. Most albuminuric T1DM patients with a normal fundus exam had angiographic signs of diabetic retinopathy, some presenting retinal malperfusion. Patients who presented retinal malperfusion had higher HbA1C and lower estimated glomerular filtration rate. Follow up time averaged 24.6 months, minimum follow up time was 20 months. Resultsįluorescein angiography revealed microaneurysms, blood-retinal barrier breakdown and retinal ischemia in 10 (67%) and 11 (73%) 8 (53%) and 9 (60%) 2 (13%) and 5 (33%) of patients at baseline and follow up, respectively. Methodsįifteen albuminuric T1DM patients with normal/near normal estimated glomerular filtration rate without diabetic retinopathy underwent fluorescein angiography presence of microaneurysms, vascular permeability changes and retinal malperfusion were evaluated. To report fluorescein angiography findings in a group of albuminuric Type 1 diabetes mellitus (T1DM) patients without diabetic retinopathy.
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