Gardner Thomas W, Antonetti David A, Barber Alistair J, LaNoue Kathryn F, Levison Steven W
Department of Ophthalmology, Penn State University College of Medicine, Hershey, PA 17033, USA.
Surv Ophthalmol. 2002 Dec;47 Suppl 2:S253-62. doi: 10.1016/s0039-6257(02)00387-9.
Retinal microvascular dysfunction in diabetes is a major component of diabetic retinopathy. This review highlights recent observations regarding the cellular anatomy that contributes to the blood-retinal barrier and its breakdown, the alterations of macroglial, neuronal, and microglial cells in diabetes, and how these changes lead to loss of vision. In addition, the effects of systemic pathophysiologic influences, including metabolic control, blood pressure, and fluid volume on the formation of diabetic macular edema are discussed. Finally, an overview of inflammatory mechanisms and responses in the retina in diabetes is provided. Together, these new observations provide a broader clinical and research perspective on diabetic retinal vascular dysfunction than previously considered, and provide new avenues for improved treatments to prevent loss of vision.
糖尿病性视网膜微血管功能障碍是糖尿病视网膜病变的主要组成部分。本综述重点介绍了有关构成血视网膜屏障及其破坏的细胞解剖结构、糖尿病中神经胶质细胞、神经元细胞和小胶质细胞的改变，以及这些变化如何导致视力丧失的最新观察结果。此外，还讨论了全身病理生理影响，包括代谢控制、血压和液体量对糖尿病性黄斑水肿形成的影响。最后，概述了糖尿病视网膜中的炎症机制和反应。这些新的观察结果共同为糖尿病视网膜血管功能障碍提供了比以往更广阔的临床和研究视角，并为预防视力丧失的改进治疗提供了新途径。
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