RISK FACTORS OF DISTURBANCE OF RETINAL MICROCIRCULATION IN PATIENTS WITH TYPE II DIABETES MELLITUS
The aim of the work was to study the risk factors for the disturbance of microcirculation of the retina in patients with type II diabetes mellitus. The study included 38 patients (38 eyes) with type II diabetes without clinically visible changes on the fundus. Ophthalmologic examination was performed before the beginning of treatment and included: best corrected visual acuity, tonometry, gonioscopy, biomicroscopy, ophthalmoscopy, optical coherence tomography.
Platelets (Tc) were isolated by centrifugation from the peripheral blood of patients. To activate Tc, subthreshold concentrations of agonists were used, which in the control group caused aggregation not exceeding 10 %. Evaluation of aggregation was carried out by spectrophotometric method using the Chrono-Log Aggregator (USA). The results of the study showed that in case of a stable background collagen level, the sensitivity of α2-adrenoreceptors Tc provides an increase in the proaggregant state of Tc with an increase in the concentration of catecholamines in the incubation mixture. A similar increase in Tc reactivity was registered in case of a stable background level of adrenaline and an increase in the concentration of collagen. The sequential introduction of adrenaline and platelet activating factor (PAF) into the Tc suspension at subthreshold concentrations was accompanied by an increase in aggregation that exceeded the isolated effect of each agonist (p <0.001). The fact of the summation of the effects of the two agonists confi rms the possibility of a joint action of adrenaline and collagen, and / or epinephrine and PAP in the activation of Tc for type II diabetes. Thus, activation of the sympathoadrenal system, endothelial dysfunction and infl ammation may be risk factors for increasing the proaggregant status of Tc and disturbing the microcirculation of the retina in patients with type II diabetes.
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