Hendrikse F, Yeo K T
Klinik für Augenheilkunde Academisch ziekenhuis Maastricht.
Klin Monbl Augenheilkd. 1993 Nov;203(5):319-23. doi: 10.1055/s-2008-1045684.
In recent years it has become evident that the vitreous must play a role in various aspects of diabetic retinopathy. The exact role of the vitreous is however in many aspects still ill defined. There are structural changes of the vitreous, as for instance vitreous liquefaction and posterior vitreous detachment, that are associated with the occurrence and earlier onset of diabetic retinopathy. Further there are angiogenic and angioinhibitory factors in the vitreous which influence neovascularisation by means of endothelial cell proliferation. Photocoagulation of the retina can cause structural changes (posterior vitreal detachment) and histological changes (increased hyalocytes activity) which can protect against the progression of proliferative diabetic retinopathy. The role of vitrectomy in protecting against proliferative diabetic retinopathy is generally concerned to be related to the removal of the vitreal scaffold. But vitrectomy can also induce changes in the oxygenation of the eye. If complete detachment of the posterior vitreous can be achieved it might be possible to further slow the progression of diabetic retinopathy.
It is possible that in the future manipulation of the vitreous by means of enzymes and lasers can play a role in the treatment and prevention of diabetic retinopathy.
近年来，玻璃体在糖尿病视网膜病变的各个方面发挥作用已变得明显。然而，玻璃体的确切作用在许多方面仍不明确。玻璃体存在结构变化，例如玻璃体液化和玻璃体后脱离，这些与糖尿病视网膜病变的发生和更早发病相关。此外，玻璃体中存在血管生成和血管抑制因子，它们通过内皮细胞增殖影响新生血管形成。视网膜光凝可导致结构变化（玻璃体后脱离）和组织学变化（玻璃体细胞活性增加），这可防止增殖性糖尿病视网膜病变的进展。玻璃体切除术在预防增殖性糖尿病视网膜病变中的作用通常被认为与去除玻璃体支架有关。但玻璃体切除术也可引起眼部氧合变化。如果能实现玻璃体后完全脱离，可能进一步减缓糖尿病视网膜病变的进展。
未来通过酶和激光对玻璃体进行操作可能在糖尿病视网膜病变的治疗和预防中发挥作用。
