PROTECTIVE EFFECT OF CAPTOPRIL ON THE BLOOD-RETINA BARRIER IN NORMOTENSIVE INSULIN-DEPENDENT DIABETIC-PATIENTS WITH NEPHROPATHY AND BACKGROUND RETINOPATHY

The effect of 18 months' inhibition of angiotensin-converting enzyme by captopril on the leakage of fluorescein through the blood-retina barrier was examined in a prospective, randomized control study of 20 normotensive insulin-dependent diabetic patients with nephropathy and background retinopathy. After 18 months, 15 patients remained in the study. Fluorescein leakage remained nearly unchanged in the captopril-treated group, being 4.1 ± 4.1 (mean ± SD) × 10-7 cm/s at baseline and 4.2±4.1 × 10-7 cm/s after 18 months' treatment. The permeability increased significantly (P<0.01) from 3.3±2.2 × 10-7 cm/s to 5.6±3.5 × 10-7 cm/s at 18 months in the control group. Arterial blood pressure was nearly constant in both groups throughout the study. The results indicate that angiotensin-converting enzyme inhibition with captopril can arrest or delay a progressive breakdown of the blood-retina barrier in normotensive insulin-dependent diabetic patients with nephropathy and background retinopathy. © 1990 Springer-Verlag.