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Association of vitreous vitamin C depletion with diabetic macular ischemia in proliferative diabetic retinopathy
PURPOSE: Vitreous vitamin C, as an anti-oxidant, is responsible for regulating oxygen tension and oxidative stress in the eye. Oxidative stress and retinal ischemia are implicated in the development of proliferative diabetic retinopathy (PDR). In this study, we aimed to determine whether vitreous le...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6583975/ https://www.ncbi.nlm.nih.gov/pubmed/31216331 http://dx.doi.org/10.1371/journal.pone.0218433 |
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author | Park, Sung Wook Ghim, Woonhyung Oh, Sanghyeon Kim, Yejin Park, Un Chul Kang, Jaeseung Yu, Hyeong Gon |
author_facet | Park, Sung Wook Ghim, Woonhyung Oh, Sanghyeon Kim, Yejin Park, Un Chul Kang, Jaeseung Yu, Hyeong Gon |
author_sort | Park, Sung Wook |
collection | PubMed |
description | PURPOSE: Vitreous vitamin C, as an anti-oxidant, is responsible for regulating oxygen tension and oxidative stress in the eye. Oxidative stress and retinal ischemia are implicated in the development of proliferative diabetic retinopathy (PDR). In this study, we aimed to determine whether vitreous level of vitamin C is compromised in patients with PDR and to investigate the association of diabetic macular ischemia and vitamin C. METHODS: This prospective study enrolled forty patients who underwent pars plana vitrectomy for the treatment of PDR (PDR group, n = 20) and idiopathic epiretinal membrane (control group, n = 20). Serum, aqueous humor, and the vitreous were collected for the analysis of vitamin C level by HPLC. Diabetic macular ischemia (DMI) in PDR group was evaluated with fluorescein angiography (FA). RESULTS: PDR patients (60.4 ± 2.1 y) were younger than non-diabetic control patients (67.4 ± 1.2 y). Serum, aqueous, and vitreous levels of vitamin C in PDR were 38.7%, 22.5%, and 11.1% of non-diabetic control group, respectively. All PDR patients had DMI (grade 1: 25%, grade 2: 30%, grade 3: 30%, grade 4: 15%). DMI grade was inversely correlated with the level of vitreous vitamin C (r = -0.546, P = 0.019), not with HbA1C, serum, or aqueous vitamin C level. In addition, the level of vitreous vitamin C (4.5 ± 2.6 μg/ml) in high DMI group (Gr 3 &4) was lower than that (31.0 ± 9.1 μg/ml) in low DMI group (Gr 1&2) (P = 0.015). CONCLUSIONS: Vitreous level of vitamin C in PDR patients showed a tenfold decrease, which was associated with the degree of macular ischemia. This suggests that vitreous vitamin C depletion may cause macula ischemia in PDR patients. |
format | Online Article Text |
id | pubmed-6583975 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-65839752019-06-28 Association of vitreous vitamin C depletion with diabetic macular ischemia in proliferative diabetic retinopathy Park, Sung Wook Ghim, Woonhyung Oh, Sanghyeon Kim, Yejin Park, Un Chul Kang, Jaeseung Yu, Hyeong Gon PLoS One Research Article PURPOSE: Vitreous vitamin C, as an anti-oxidant, is responsible for regulating oxygen tension and oxidative stress in the eye. Oxidative stress and retinal ischemia are implicated in the development of proliferative diabetic retinopathy (PDR). In this study, we aimed to determine whether vitreous level of vitamin C is compromised in patients with PDR and to investigate the association of diabetic macular ischemia and vitamin C. METHODS: This prospective study enrolled forty patients who underwent pars plana vitrectomy for the treatment of PDR (PDR group, n = 20) and idiopathic epiretinal membrane (control group, n = 20). Serum, aqueous humor, and the vitreous were collected for the analysis of vitamin C level by HPLC. Diabetic macular ischemia (DMI) in PDR group was evaluated with fluorescein angiography (FA). RESULTS: PDR patients (60.4 ± 2.1 y) were younger than non-diabetic control patients (67.4 ± 1.2 y). Serum, aqueous, and vitreous levels of vitamin C in PDR were 38.7%, 22.5%, and 11.1% of non-diabetic control group, respectively. All PDR patients had DMI (grade 1: 25%, grade 2: 30%, grade 3: 30%, grade 4: 15%). DMI grade was inversely correlated with the level of vitreous vitamin C (r = -0.546, P = 0.019), not with HbA1C, serum, or aqueous vitamin C level. In addition, the level of vitreous vitamin C (4.5 ± 2.6 μg/ml) in high DMI group (Gr 3 &4) was lower than that (31.0 ± 9.1 μg/ml) in low DMI group (Gr 1&2) (P = 0.015). CONCLUSIONS: Vitreous level of vitamin C in PDR patients showed a tenfold decrease, which was associated with the degree of macular ischemia. This suggests that vitreous vitamin C depletion may cause macula ischemia in PDR patients. Public Library of Science 2019-06-19 /pmc/articles/PMC6583975/ /pubmed/31216331 http://dx.doi.org/10.1371/journal.pone.0218433 Text en © 2019 Park et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Park, Sung Wook Ghim, Woonhyung Oh, Sanghyeon Kim, Yejin Park, Un Chul Kang, Jaeseung Yu, Hyeong Gon Association of vitreous vitamin C depletion with diabetic macular ischemia in proliferative diabetic retinopathy |
title | Association of vitreous vitamin C depletion with diabetic macular ischemia in proliferative diabetic retinopathy |
title_full | Association of vitreous vitamin C depletion with diabetic macular ischemia in proliferative diabetic retinopathy |
title_fullStr | Association of vitreous vitamin C depletion with diabetic macular ischemia in proliferative diabetic retinopathy |
title_full_unstemmed | Association of vitreous vitamin C depletion with diabetic macular ischemia in proliferative diabetic retinopathy |
title_short | Association of vitreous vitamin C depletion with diabetic macular ischemia in proliferative diabetic retinopathy |
title_sort | association of vitreous vitamin c depletion with diabetic macular ischemia in proliferative diabetic retinopathy |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6583975/ https://www.ncbi.nlm.nih.gov/pubmed/31216331 http://dx.doi.org/10.1371/journal.pone.0218433 |
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