HISTOPATHOLOGY OF DIABETIC-RETINOPATHY IN MAN
HISTOPATHOLOGY OF DIABETIC-RETINOPATHY IN MAN
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作者：
GARNER, A
与糖尿病相关的视网膜变化是系统性微血管病的结果，其改变与眼内环境相关。背景性视网膜病变的基础血管疾病是小动脉玻璃样变性（与循环血液中的异常一起可引起局灶性毛细血管闭合）、小静脉扩张和毛细血管病，其形式为周细胞变性、基底膜增厚和微动脉瘤形成。视网膜并发症包括血浆渗出和点状出血。黄斑病变是由于囊样水肿。毛细血管闭合增加与棉絮斑和视网膜内微血管异常有关，前者反映了缺血增加的后果，后者反映了对缺血增加的反应。视网膜前的血管增生起源于靠近缺血区域的小静脉;内皮最初可能是有孔的，纤维化可能伴随着新血管。
The retinal changes associated with diabetes mellitus are a consequence of the systemic microangiopathy with modifications related to the intraocular environment. The vascular disorders underlying background retinopathy are arteriolar hyalinosis (which together with abnormalities in the circulating blood can give rise to focal capillary closure), venular dilatation, and capillaropathy in the form of pericyte degeneration, basement membrane thickening and microaneurysm formation. Retinal complications consist of plasma exudation and punctate haemorrhages. Maculopathy is due to cystoid oedema. Increasing closure of capillaries is linked with cotton-wool spots and intraretinal microvascular anomalies, the former reflecting a consequence and the latter a response to increased ischaemia. Vascular proliferation in front of the retina originates from venules close to areas of ischaemia; the endothelium may be fenestrated initially and fibrosis may accompany the new vessels.