We read with interest the article by Klein et al on the relation of retinal vessel caliber to the progression of diabetic retinopathy.1 The role of retinal vasodilatation in the progression of diabetic retinopathy has been keen interest of ours for many years, and in 1983 we proposed that vasodilatation was an important feature and even played a causal role in the progression of diabetic and other ischemic retinopathies.2,3 In this review paper, “the vasodilatation in the retina was discussed in terms of a model in which vessel wall stretch in the retinal venules leads to leakage and proliferation.”2 The vasodilatation hypothesis was not well received by opinion leaders in ophthalmology at the time, and little support was available to pursue research in this field. Despite this, we were able to provide and publish information on the relationship between retinal vessel caliber and the progression of diabetic retinopathy. Specifically, in the field of macular edema, we were able to show that retinal arterioles and venules show progressive dilatation before the diagnosis of diabetic macular edema4 and constriction of these vessels following the successful laser treatment of diabetic macular edema.5
Stefansson E, Landers MB, Wolbarsht M. Retinal Vessel Caliber and Diabetic Retinopathy. Arch Ophthalmol. 2005;123(5):709. doi:10.1001/archopht.123.5.709-a
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