Diabetic retinopathy: Early functional changes
Diabetic retinopathy: Early functional changes
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DOI：
10.1111/j.1440-1681.1997.tb02133.x
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发表时间：
1997-09-01
影响因子：
2.9
通讯作者：
Yu, PK
中科院分区：
文献类型：
--
作者：
Alder, VA;Su, EN;Yu, PK
1. 本综述报道了在糖尿病动物模型中，在出现任何临床或解剖学变化之前，糖尿病视网膜所发生的一些最早的生理变化。
2. 在大鼠中使用化学诱导糖尿病（链脲佐菌素诱导），在持续高血糖5周后测定视网膜血流以及玻璃体和视网膜的氧张力。与对照组相比，糖尿病组的血流更大，并且血流也重新分布。同时，视网膜小动脉周围的氧张力分布发生改变，这意味着在这些早期糖尿病视网膜中视网膜氧消耗增加。
3. 使用离体灌注眼标本证实了血流变化可能是由于视网膜血管的控制机制改变所致。在糖尿病4周后，糖尿病眼中对测试药物的反应性发生改变。
4. 为了进一步探究这些血管反应变化，我们开发了一种离体灌注视网膜小动脉标本，在该标本中可以对血管的各个部分进行测试。证实了胰岛素对视网膜小动脉有直接的血管舒张作用，并证明其通过血管内皮细胞释放的一氧化氮起作用。这些数据可能表明糖尿病引起的胰岛素变化与早期视网膜变化有关。
5. 有证据表明，尽管早期血糖控制对于阻止糖尿病视网膜病变的发生可能至关重要，但在诱导的糖尿病级联反应中，会出现一个阶段，如果视网膜病变已经开始，良好的血糖控制无法阻止视网膜病变的进一步进展。
1. The present review reports some of the earliest physiological changes that occur in the diabetic retina prior to any clinical or anatomical changes in an animal model of diabetes,2. Using chemically induced diabetes (by streptozotocin) in rats, retinal blood flow and vitreal and retinal oxygen tension were determined after 5 weeks of sustained hyperglycaemia, Blood flow was greater and was also redistributed in the diabetic group compared with values for the control group, At the same time, oxygen tension distribution was altered around retinal arterioles, implying an increase in retinal oxygen consumption in these early diabetic retinas,3. The possibility that the blood flow changes could be due to altered control mechanisms in the retinal vasculature was confirmed using an isolated, perfused eye preparation, In diabetic eyes an altered reactivity to test pharmacological agents was demonstrated after 4 weeks of diabetes,4, To further explore these vascular response changes we developed an isolated, perfused retinal arteriolar preparation in which individual segments of the vasculature can be tested, The possibility that insulin has a direct vasodilator effect on retinal arterioles was confirmed and was demonstrated to act via nitric oxide released from the vascular endothelial cells, These data may implicate the diabetic-induced insulin changes in early retinal changes,5, Evidence is presented that although early glucose control may be vital in stopping the onset of diabetic retinopathy, there comes a stage in the induced diabetic cascade where if the retinopathy has commenced, good glucose control cannot stop the further progression of the retinopathy.