Marfan Syndrome and Early-Onset Diabetic Retinopathy: A Case Report

Y Ka; M Cristina; B Adel; M Johnson; L Chui; D Hugh

International Journal of Endocrinology and Metabolism

Research Institute for Endocrine Sciences

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Marfan Syndrome and Early-Onset Diabetic Retinopathy: A Case Report

Author(s):

Y Park Ka¹,

M Aydin Cristina²,

B Mazanderani Adel²,

M Johnson²,

L Chui²,

D Tildesley Hugh^3,*

1Department of Family Medicine, University of Toronto, Canada

2Department of Medi-cine,University of British Columbia, Canada

3Department of Medi-cine,University of British Columbia and Division of Endocrinology, St. Pauls Hospital, hught@istar.ca, Canada

International Journal of Endocrinology and Metabolism:Vol. 7, issue 1; 41-45

Article type:Case Report

Received:Dec 25, 2008

Accepted:Jan 10, 2009

How to Cite:Y Park KaM Aydin CristinaB Mazanderani AdelM JohnsonL ChuiD Tildesley Hughet al.Marfan Syndrome and Early-Onset Diabetic Retinopathy: A Case Report.Int J Endocrinol Metab.7(1):41-45.

Abstract

Diabetic retinopathy is characterized by the proliferation of fibrovascular tissue extending from the retina into the vi-treous cavity. MFS is an autosomal do-minant disorder of the elastic tissue. Al-though MFS clearly manifests with multiple ocular problems, there is no reported association between MFS and diabetic retinopathy. Reported here is the case of 32-year-old male with Marfan Syndrome (MFS) and type 2 diabetes mellitus (DM) presented with an accelerated onset of diabetic retinopathy. Our patient developed diabetic retinopathy only 4 years following the diagnosis of type 2 DM, de-spite excellent glucose control. We suggest that there may be a pathophysiological link between MFS and diabetes involving extracellular matrix components that accelerates and/or augments the retinopathic processes in MFS patients. Specifical-ly, we postulate that increased levels of matrix metalloproteinases (MMP) and transforming growth factor beta (TGF-β) in diabetic retinas fa-cilitate the proteolysis of an already weakened ocular connective tissue in MFS, ultimately lead-ing to early development of ophthalmologic ma-nifestations such as diabetic retinopathy.

Keywords

Marfan syndrome

Diabetic retino-pathy

Type 2 diabetes

Matrix metalloproteinases

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