Effect of antihypertensive treatment on blood-retinal barrier permeability to fluorescein in hypertensive Type 1 (insulin-dependent) diabetic patients with background retinopathy

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Abstract
The effect of antihypertensive treatment on blood-retinal barrier leakage of fluorescein in background retinopathy was studied in nine hypertensive Type 1 (insulin-dependent) diabetic patients suffering from nephropathy. The patients were investigated before and after 7 (3 to 13) months of treatment with captopril (n=8; 25 to 100 mg daily) and a diuretic, either frusemide (n=4; 80 to 200 mg daily) or bendrofluazide (n=2; 2.5 mg daily). Retinal function was assessed by fundus photography, fluorescein angiography, vitreous fluorometry, and renal function by glomerular filtration rate, and albuminuria. The antihypertensive treatment induced a significant reduction (p−7 cm/second; albuminuria from 1391 (range: 168–4852) μg/min to 793 (range: 35–2081) ug/min. Glomerular filtration rate declined from 88±15 to 78±23 ml·min−1·1.73 m2 (0.05<p1c levels remained stable during the study. Our study suggests that systemic blood pressure elevation contributes to the abnormal blood-retinal barrier permeability to fluorescein characteristically found in diabetic background retinopathy and that this abnormality can be reversed during antihypertensive treatment.