Role of Endothelial Dysfunction and Arterial Stiffness in the Development of Diabetic Retinopathy

Diabetic retinopathy (DR) remains one of the most important diabetic microvascular complications and a leading cause of irreversible blindness, highlighting the importance of close monitoring. The atherosclerotic progression in patients with insulin resistance is precipitated by endothelial dysfunction and vascular impairment (1). Therefore, we examined the association of endothelial dysfunction and arterial stiffness with DR and how these measurements can be used for the early identification and monitoring of patients at high risk to develop DR. In this case-control study, we included 100 healthy control (CL) subjects and 200 consecutive subjects with type 2 diabetes recruited from the 1st Department of Ophthalmology of the University of Athens Medical School where they were referred to evaluate for DR. All participants underwent a complete ophthalmological examination by the same experienced ophthalmologist, which included fundoscopy after pupillary dilation, fluorescein angiography, and colorful fundus photographs. The diabetic patients, according to the Early Treatment Diabetic Retinopathy Study (ETDRS) classification, were categorized into three groups: 1 ) no DR (NDR) (108 …