Blood-retinal barriers in juvenile diabetics in relation to early clinical manifestations, HLA-DR types, and metabolic control. 1985

A Kernell, and J Ludvigsson

Eighty-seven diabetics 8.5-26 years old (mean +/- SD 15.3 +/- 3.9) and 32 healthy non-diabetic controls 8-27 years old (13.9 +/- 4.3) were included in the study. They had had the disease for 2 months to 19 years (5.8-4.0 years). Seventy-two of the diabetic patients were HLA-DR type, 13 patients had DR 3 alone, 25 DR4, 33 DR 3,4 and 1 patient was neither DR 3 nor 4. The mean fluorescein concentration in the vitreous body 3.5-7 mm from the retinal surface at 60 min after intravenous administration of fluorescein was 15.5 +/- 11.9 ng/ml in the diabetics and 7.2 +/- 3.7 ng/ml in the non-diabetic controls (P less than 0.001). The diabetics still in partial remission had an almost normal blood-retinal barrier (BRB; 7.9 +/- 4.8 ng/ml) while about 55% of the diabetics beyond remission had impaired barrier function. Abnormal leakage was found in some patients who had had diabetes for less than 2 years and also before the onset of puberty. The incidence of abnormal leakage increased with increasing age and duration. There was a positive correlation between fluorescein leakage and the blood glucose level at the onset of diabetes (P less than 0.01). There was no statistically significant relationship between specific HLA-DR types and abnormal leakage. A defect BRB was significantly correlated with poor short-term metabolic controls, expressed as glucosuria index during the last week before examination with vitreous fluorophotometry. Prospective studies will show whether abnormal BRB gradually leads to irreversible retinopathy.

UI MeSH Term Description Entries
D010783 Photometry Measurement of the various properties of light. Photometries
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D003922 Diabetes Mellitus, Type 1 A subtype of DIABETES MELLITUS that is characterized by INSULIN deficiency. It is manifested by the sudden onset of severe HYPERGLYCEMIA, rapid progression to DIABETIC KETOACIDOSIS, and DEATH unless treated with insulin. The disease may occur at any age, but is most common in childhood or adolescence. Diabetes Mellitus, Brittle,Diabetes Mellitus, Insulin-Dependent,Diabetes Mellitus, Juvenile-Onset,Diabetes Mellitus, Ketosis-Prone,Diabetes Mellitus, Sudden-Onset,Diabetes, Autoimmune,IDDM,Autoimmune Diabetes,Diabetes Mellitus, Insulin-Dependent, 1,Diabetes Mellitus, Type I,Insulin-Dependent Diabetes Mellitus 1,Juvenile-Onset Diabetes,Type 1 Diabetes,Type 1 Diabetes Mellitus,Brittle Diabetes Mellitus,Diabetes Mellitus, Insulin Dependent,Diabetes Mellitus, Juvenile Onset,Diabetes Mellitus, Ketosis Prone,Diabetes Mellitus, Sudden Onset,Diabetes, Juvenile-Onset,Diabetes, Type 1,Insulin Dependent Diabetes Mellitus 1,Insulin-Dependent Diabetes Mellitus,Juvenile Onset Diabetes,Juvenile-Onset Diabetes Mellitus,Ketosis-Prone Diabetes Mellitus,Sudden-Onset Diabetes Mellitus
D005452 Fluoresceins A family of spiro(isobenzofuran-1(3H),9'-(9H)xanthen)-3-one derivatives. These are used as dyes, as indicators for various metals, and as fluorescent labels in immunoassays. Tetraiodofluorescein
D005947 Glucose A primary source of energy for living organisms. It is naturally occurring and is found in fruits and other parts of plants in its free state. It is used therapeutically in fluid and nutrient replacement. Dextrose,Anhydrous Dextrose,D-Glucose,Glucose Monohydrate,Glucose, (DL)-Isomer,Glucose, (alpha-D)-Isomer,Glucose, (beta-D)-Isomer,D Glucose,Dextrose, Anhydrous,Monohydrate, Glucose
D006029 Glycosuria The appearance of an abnormally large amount of GLUCOSE in the urine, such as more than 500 mg/day in adults. It can be due to HYPERGLYCEMIA or genetic defects in renal reabsorption (RENAL GLYCOSURIA).
D006684 HLA-DR Antigens A subclass of HLA-D antigens that consist of alpha and beta chains. The inheritance of HLA-DR antigens differs from that of the HLA-DQ ANTIGENS and HLA-DP ANTIGENS. HLA-DR,Antigens, HLA-DR,HLA DR Antigens
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000293 Adolescent A person 13 to 18 years of age. Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults

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