Gamulescu M A, Renner A B, Helbig H
Augenklinik, Universitätsklinikum Regensburg, Regensburg, Deutschland.
Ophthalmologe. 2009 Apr;106(4):305-10. doi: 10.1007/s00347-008-1870-4.
The retinal pigment epithelium (RPE) serves a variety of different functions and impairment of these functions can lead to a multitude of different diseases of the posterior segment of the eye. The RPE plays an important role as an ion and fluid pump for the reabsorption of subretinal fluid in retinal detachment. On the other hand, defects in this pump function and in the outer blood-retinal barrier formed by the RPE, lead to fluid retention in inflammatory diseases. Metaplasia of RPE cells to myofibroblasts can lead to proliferative vitreoretinopathy and tractive retinal detachment. Early age-related maculopathy is caused by disturbances of phagocytosis and metabolism of the RPE. Imbalance of the physiological equilibrium between vasoproliferative and vasoinhibitory factors secreted by the RPE is probably involved in the development of atrophic or neovascular forms of advanced age-related macular degeneration. Mutations in the different steps involved in regeneration of the visual pigment (visual cycle) may lead to retinal dystrophy. Finally, immunoregulatory properties of the RPE are responsible for the phenomenon of immunological privilege, which may facilitate clinical interventions such as gene therapy and RPE transplantation.
视网膜色素上皮（RPE）具有多种不同功能，这些功能的损害可导致多种不同的眼后段疾病。RPE作为离子和液体泵，在视网膜脱离时对视网膜下液的重吸收起着重要作用。另一方面，该泵功能以及由RPE形成的外血视网膜屏障的缺陷，会导致炎症性疾病中的液体潴留。RPE细胞向肌成纤维细胞的化生可导致增殖性玻璃体视网膜病变和牵拉性视网膜脱离。早期年龄相关性黄斑病变是由RPE吞噬作用和代谢紊乱引起的。RPE分泌的血管增殖因子和血管抑制因子之间的生理平衡失衡可能与萎缩性或新生血管性晚期年龄相关性黄斑变性的发生有关。视觉色素再生（视觉循环）所涉及的不同步骤中的突变可能导致视网膜营养不良。最后，RPE的免疫调节特性导致了免疫赦免现象，这可能有助于基因治疗和RPE移植等临床干预。
