VASCULAR CHANGES IN DIABETES WITH PARTICULAR REFERENCE TO THE RETINAL VESSELS - PRELIMINARY REPORT
VASCULAR CHANGES IN DIABETES WITH PARTICULAR REFERENCE TO THE RETINAL VESSELS - PRELIMINARY REPORT
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DOI：
10.1136/bjo.33.7.407
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发表时间：
1949-01-01
影响因子：
4.1
通讯作者：
ASHTON, N
中科院分区：
文献类型：
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作者：
ASHTON, N
真正的动脉瘤，其中大部分是囊状憩室，发现于糖尿病视网膜病变。它们主要局限于毛细血管网的静脉侧，并且它们大部分位于连接更深和更浅的视网膜毛细血管丛的毛细血管的过程中的内核层中。深静脉丛是一个比浅静脉丛更紧密的网状结构，因此静脉淤滞对深静脉丛的影响大于浅静脉丛。微动脉瘤对内核层的偏好可能纯粹是该区域停滞增加的表现。视网膜是眼睛和身体中发现微动脉瘤的唯一部位。在一个小系列中，所有结节型毛细血管间肾小球硬化（肾Kimmelstiel-Wilson病）的病例都与糖尿病视网膜病变有关。肾脏和视网膜的血管病变可能是同一病理过程的表现，只是由于这两个器官的解剖结构不同而有所不同。前者的毛细血管间（也许是壁内）透明质沉积可能与视网膜血管壁变性和增生后视网膜中的蜡样渗出物密切相关。然而，糖尿病视网膜病变可以在没有肾Kimmelstiel-Wilson病的情况下存在。
True aneurysms, most of which are saccular diverticula, are found in diabetic retinopathy. They are largely confined to the venous side of the capillary network, and they are situated, for the most part, in the inner nuclear layer in the course of the capillaries which link the deeper and more superficial retinal capillary plexuses. The deeper plexus is a more closely knit meshwork than the superficial one, and therefore venous stasis affects the former more than the latter. The preference of the micro-aneurysms for the inner nuclear layer may be purely an expression of the increased stasis in that region. The retina was the only part of the eye and of the body in which micro-aneurysms were found. All the cases, in a small series, of intercapillary glomerulosGlerosis of the nodular type (Kimmelstiel-Wilson''s disease of the kidney) were associated with diabetic retinopathy. These vascular lesions of the kidney and retina may be manifestations of the same pathological process only modified by the different anatomical structure of the 2 organs. The intercapillary (and perhaps intramural) deposits of hyalin in the former may be closely related to the waxy exudates in the retina which follow degeneration and proliferation of the walls of the retinal vessels. However, diabetic retinopathy can exist in the absence of Kimmelstiel-Wilson''s disease of the kidney.