Nguyen Thanh T, Wong Tien Yin
Curr Diab Rep. 2009 Aug;9(4):277-83. doi: 10.1007/s11892-009-0043-4.
Recent studies support the concept that the retinal vasculature may provide a summary measure of lifetime exposure to the effects of hyperglycemia. Advances in retinal photographic techniques and in image analysis have allowed objective and precise in vivo measurement of retinal vascular changes. In particular, quantitative assessment of retinopathy signs and measurement of retinal vascular caliber have greatly increased our knowledge of early microcirculatory alterations in prediabetes, diabetes, and diabetic micro- and macrovascular complications. Data from recent population-based studies suggest that retinal arteriolar and venular caliber changes reflect different pathophysiologic processes. Retinal arteriolar narrowing, for example, is associated with risk of diabetes and coronary artery disease, whereas retinal venular widening is associated with development and progression of diabetic retinopathy and risk of stroke. Studying these changes offers the potential to improve our understanding of the early pathophysiologic pathways of diabetes development and its complications. Future research will assess the ability of retinal vascular imaging to provide clinically useful prognostic information for patients with diabetes.
近期研究支持这样一种观点，即视网膜血管系统可能提供了对高血糖影响的终生暴露的总体衡量指标。视网膜摄影技术和图像分析的进展使得对视网膜血管变化进行客观、精确的体内测量成为可能。特别是，对视网膜病变体征的定量评估和视网膜血管管径的测量极大地增进了我们对糖尿病前期、糖尿病以及糖尿病微血管和大血管并发症早期微循环改变的认识。近期基于人群的研究数据表明，视网膜小动脉和小静脉管径变化反映了不同的病理生理过程。例如，视网膜小动脉变窄与糖尿病和冠状动脉疾病风险相关，而视网膜小静脉增宽与糖尿病视网膜病变的发生和进展以及中风风险相关。研究这些变化有可能增进我们对糖尿病发生及其并发症早期病理生理途径的理解。未来的研究将评估视网膜血管成像为糖尿病患者提供临床有用预后信息的能力。
