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

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.