Larkins R G, Dunlop M E, Johnson E I
University of Melbourne, Department of Medicine, Royal Melbourne Hospital, Parkville, Victoria.
Aust N Z J Ophthalmol. 1996 May;24(2):97-104. doi: 10.1111/j.1442-9071.1996.tb01561.x.
Diabetic retinopathy remains a major cause of loss of vision. The Diabetes Control and Complications Trial (DCCT) has implicated hyperglycaemia as a probable major direct causative factor in the pathogenesis of diabetic retinopathy. There are several plausible mechanisms by which high glucose concentrations could lead to the functional and later structural changes characterising diabetic retinopathy. These include increased activity of the aldose reductase pathway, increase de novo synthesis of diacylglycerol from glucose, causing protein kinase C activation, increased non-enzymatic glycation and increased oxidative damage. The demonstration of the potential roles of these pathways and the subsequent effects of growth factors in enhancing angiogenesis provide potential new approaches to the prevention and treatment of diabetic retinopathy.
糖尿病视网膜病变仍然是视力丧失的主要原因。糖尿病控制与并发症试验（DCCT）表明，高血糖可能是糖尿病视网膜病变发病机制中的一个主要直接致病因素。高血糖浓度可能通过几种合理的机制导致糖尿病视网膜病变的功能性改变以及随后的结构性改变。这些机制包括醛糖还原酶途径活性增加、葡萄糖从头合成二酰甘油增加导致蛋白激酶C激活、非酶糖基化增加以及氧化损伤增加。这些途径的潜在作用以及生长因子在促进血管生成方面的后续作用的证实，为糖尿病视网膜病变的预防和治疗提供了潜在的新方法。
