Pathophysiology of diabetic retinopathy
Authors:
T. Sosna
Authors place of work:
Primář: MUDr. Karel Sedláček
; Oční oddělení Fakultní Thomayerovy nemocnice, Praha
Published in the journal:
Prakt. Lék. 2009; 89(2): 89-92
Category:
Of different specialties
Summary
The basic pathogenic mechanism of diabetic retinopathy is hyperglycaemia. Capillary damage can be explained by several mechanisms: sorbitol overload, excessive storage of advanced glycosylation endproducts, oxidative stress or also cell apoptosis after paradoxical glucose starvation. In this article, the mechanism of capillary damage of the retina on the basis of haemorheological, hemodynamic and histopathologic changes is further analyzed. The specific influence of the retinal pigment epithelium is emphasized. Histopathological changes lead to basic microcirculatory anomalies caused by pericyte apoptotic cell death, damage of endothelial cells and the basal membrane. These changes lead to capillary dilatation, vascular occlusion and proliferation of new vessels, which is the main reason for further development of diabetic retinopathy.
Key words:
pathophysiology, diabetic retinopathy, hyperglycaemia, pericytes, endothelial cells.
Zdroje
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