Bek T
Department of Ophthalmology, Arhus University Hospital, Denmark.
Acta Ophthalmol (Copenh). 1994 Aug;72(4):409-15. doi: 10.1111/j.1755-3768.1994.tb02787.x.
The histopathology of capillary-free areas in diabetic retinopathy was studied in 27 lesions from 12 human donor eyes. Localised capillary-free areas were identified on casts of the retinal vascular system, and on subsequent histological sections of these areas the casted vessels acted as points of reference to accurately combine the histological appearance of the retina with the vascular morphology as seen on the cast. All studies lesions showed inner retinal changes with loss of ganglion cells, attenutation of the inner nuclear layer and hyalinization of the retinal capillary network. In 21 of the studied lesions a homogeneous eosinophil substance was seen accumulated between the photoreceptor outer segments and the retinal pigment epithelium corresponding to the areas with inner retinal changes. The findings may help explain the blocking of choroidal fluorescence in capillary-free areas as seen on fluorescein angiograms in diabetic retinopathy. The study suggests future guidelines for further illumination of the pathophysiology of proliferative diabetic retinopathy.
对12只人类供体眼睛的27个病变进行了糖尿病视网膜病变中无毛细血管区域的组织病理学研究。在视网膜血管系统铸型上识别出局部无毛细血管区域，在这些区域随后的组织学切片上，铸型血管作为参考点，以便准确地将视网膜的组织学外观与铸型上所见的血管形态相结合。所有研究病变均显示视网膜内层改变，包括神经节细胞丢失、内核层变薄以及视网膜毛细血管网络玻璃样变性。在21个研究病变中，在与视网膜内层改变区域相对应的光感受器外段和视网膜色素上皮之间可见一种均匀的嗜酸性物质积聚。这些发现可能有助于解释糖尿病视网膜病变荧光素血管造影中无毛细血管区域脉络膜荧光的阻断现象。该研究为进一步阐明增殖性糖尿病视网膜病变的病理生理学提出了未来的指导方针。
