The pathogenetic substantiation of the use of angiotensin-converting enzyme for the treatment of diabetic retinopathy

Cover Page


The objective of the present work was to study visual functions, as well as changes in the systemic and local renin-angiotensin system before and after intake of the ACE inhibitor perindopril in 65 patients (130 eyes) presenting with diabetic retinopathy. The treatment caused the most pronounced changes in the patients with preproliferative diabetic retinopathy including the two-fold (p<0.05) decrease of ACE activity in the blood and its 7.5-fold (p<0.05) increase in the tears. These effects appear to be attributable to the action of perindopril on the levels of the proangiogenic factors known to be elevated in the patients with severe retinal ischemia. The treatment of patients with diabetic macular oedema with perindopril resulted in the decrease of the retinal thickness from 392.5±46.7 to 347.2±39.6 mcm in the absence of significant improvement in the acuteness of vision. All the patients experienced a significant reduction in the level of glycosylated hemoglobin.

M V Riabina


N B Chesnokova

T D Okhotsimskaia

T P Kuznetsova

  1. Балаболкин М.И. Диабетология. М: Медицина 2000; 345.
  2. Дедов И.И., Шестакова М.В. Сахарный диабет и артериальная гипертензия. М: МИА 2006; 345.
  3. Antonetti D.A., Klein R., Gardner T.W. Diabetic retinopathy. N Engl J Med 2012; 366: 13: 1227-1239.
  4. Lang G.E. Diabetic retinopathy. Development in ophthalmology. Basel: Karger 2007; 39.
  5. Opie L.Н. Angiotensin-Converting Enzyme Inhibitors. The Advance Continues. New York: Author,s Publishing House 1999; 315.
  6. Карпов Ю.А. Артериальная гипертония у больных сахарным диабетом: основные направления лечения. Рус мед журн 2001; 9: 24: 11-15.
  7. Hammes H.P., Porta M. Experimental Approaches to Diabetic Retinopathy. Frontiers of Diabets. Basel: Karger 2010; 20.
  8. Dancer A.H. Local renin-angiotesin system: the unanswered questions. Int J Biochem Cell Biol 2003; 35: 759-768.
  9. Fletcher E.L., Phipps J.A., Ward M.M., Vessey K.A., Wilkinson-Berka J.L. The renin-angiotensin system in retinal health and disease: Its influence on neurons, glia and the vasculature. Prog Retin Eye Res 2010; 29: 4: 284-311.
  10. Kohner E.M. The renin-angiotensin system and diabetic retinopathy. Klin Wochenschr 1992; 69: Suppl 29: 25-27.
  11. Hammes H.P., Feng Y., Pfister F., Brownlee M. Diabetic Retinopathy: Targeting Vasoregression. Diabetes 2011; 60: 1: 9-16.
  12. Павленко Т.А. Ангиотензин-превращающий фермент в тканевых структурах и жидких средах глаза в норме и патологии, пути регуляции: Автореф. дис. ... канд. мед. наук. М 2009.
  13. Wilkinson-Berka J.L. Angiotensin and diabetic retinopathy. Int J Biochem Cell Biol 2006; 38: 5-6: 752-765.
  14. Нероев В.В., Рябина М.В., Охоцимская Т.Д., Зуева М.В., Цапенко И.В. О применении препарата "Периндоприл" в лечении больных диабетической ретинопатией. Вестн офтальмол 2006; 4: 123: 4: 31-33.
  15. Нероев В.В., Чеснокова Н.Б., Охоцимская Т.Д., Рябина М.В., Кост О.А., Никольская И.И., Павленко Т.А. Активность ангио­тензинпревращающего фермента в крови и слезе у больных с диабетической ретинопатией. Вестн офтальмол 2006; 3: 122: 3: 11-14.
  16. Алтынбаев У.Р. Прогнозирование и профилактика осложнений хирургического лечения пролиферативной диабетической ретинопатии: Автореф. дис. ... канд. мед. наук. Уфа 2006.
  17. Larsen M., Hommel E., Parving H.H., Lund-Andersen H. Protective effect of captopril on the blood-retina barrier in normotensive insulin-dependent diabetic patients with nephropathy and background retinopathy. Graefes Arch Clin Exp Ophthalmol 1990; 228: 505-509.
  18. Chase H.P., Garg S.K., Harris S., Hoops S., Jackson W.E., Holmes D.L. Angiotensin-converting enzyme inhibitor treatment for young normotensive diabetic subjects: a two-year trial. Ann Ophthalmol 1993; 25: 284-289.
  19. Chaturvedi N., Porta M., Klein R., Orchard T., Fuller J., Parving H.H., Bilous R., Sjolie A.K. for the DIRECT Programme Study Group: Effect of candesartan on prevention (DIRECT-Prevent 1) and progression (DIRECT-Protect 1) of retinopathy in type 1 diabetes: randomised, placebo-controlled trials. Lancet 2008; 372: 1394-1402.
  20. Chaturvedi N., Sjolie A.-K., Stephenson J.M., Abrahamian H., Keipes M., Castellarin A., Rogulja-Pepeonik Z., Fuller J.H. the EUCLID Study Group: Effect of lisinopril on progression of retinopathy in normotensive people with type 1 diabetes. Lancet 1998; 351: 28-31.


Abstract - 481




Copyright (c) 2012 Riabina M.V., Chesnokova N.B., Okhotsimskaia T.D., Kuznetsova T.P.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies