Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, South Carolina, USA.
Department of Molecular and Cellular Physiology, Louisiana State University Health Shreveport, Shreveport, Louisiana, USA.
Compr Physiol. 2020 Jul 8;10(3):933-974. doi: 10.1002/cphy.c190021.
In this article, we present a discussion of diabetes and its complications, including the macrovascular and microvascular effects, with the latter of consequence to the retina. We will discuss the anatomy and physiology of the retina, including aspects of metabolism and mechanisms of oxygenation, with the latter accomplished via a combination of the retinal and choroidal blood circulations. Both of these vasculatures are altered in diabetes, with the retinal circulation intimately involved in the pathology of diabetic retinopathy. The later stages of diabetic retinopathy involve poorly controlled angiogenesis that is of great concern, but in our discussion, we will focus more on several alterations in the retinal circulation occurring earlier in the progression of disease, including reductions in blood flow and a possible redistribution of perfusion that may leave some areas of the retina ischemic and hypoxic. Finally, we include in this article a more recent area of investigation regarding the diabetic retinal vasculature, that is, the alterations to the endothelial surface layer that normally plays a vital role in maintaining physiological functions. © 2020 American Physiological Society. Compr Physiol 10:933-974, 2020.
在本文中，我们讨论了糖尿病及其并发症，包括大血管和微血管的影响，后者对视网膜有影响。我们将讨论视网膜的解剖和生理学，包括代谢和氧合机制的各个方面，后者通过视网膜和脉络膜血液循环的结合来实现。这两种血管在糖尿病中都发生了改变，视网膜循环与糖尿病性视网膜病变的病理学密切相关。糖尿病性视网膜病变的晚期涉及到不受控制的血管生成，这是非常令人担忧的，但在我们的讨论中，我们将更多地关注疾病进展早期视网膜循环发生的一些变化，包括血流量减少和可能的灌注重新分布，这可能导致视网膜的某些区域发生缺血和缺氧。最后，我们在本文中还包括了一个关于糖尿病视网膜血管的较新的研究领域，即内皮表面层的改变，该表面层在维持生理功能方面起着至关重要的作用。© 2020 美国生理学会。《综合生理学》9:933-974, 2020。
