Microvascular Modifications in Diabetic Retinopathy
Microvascular Modifications in Diabetic Retinopathy
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DOI：
10.1007/s11892-011-0204-0
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发表时间：
2011-08-01
影响因子：
4.2
通讯作者：
Herman, Ira M.
中科院分区：
文献类型：
--
作者：
Durham, Jennifer T.;Herman, Ira M.
患有糖尿病的患者罹患多种威胁视力的疾病的风险较高，包括增殖性糖尿病视网膜病变 (DR)。 DR表现为两个阶段：首先，视网膜微血管受损，毛细血管发生变性；随后，过度代偿性血管生成反应开始。视网膜微循环的早期变化包括血流中断、基底膜增厚、壁细胞的最终损失以及无细胞毛细血管的形成。内皮细胞凋亡和毛细血管脱落导致视网膜内层缺氧、生长因子改变和炎症介质上调。随着疾病进展，病理性血管生成产生异常的视网膜前微血管。目前的治疗方法，包括全视网膜光凝术和玻璃体切除术，几十年来一直没有改变。随着一些令人兴奋的临床前进展，新兴技术和创新细胞靶标可能为开发“下一代”介入或预防性临床方法带来新的希望，从而显着提高当前的护理标准和临床结果。
Patients struggling with diabetes are at elevated risks for several sight-threatening diseases, including proliferative diabetic retinopathy (DR). DR manifests in two stages: first, the retinal microvasculature is compromised and capillary degeneration occurs; subsequently, an over-compensatory angiogenic response is initiated. Early changes in the retinal microcirculation include disruptions in blood flow, thickening of basement membrane, eventual loss of mural cells, and the genesis of acellular capillaries. Endothelial apoptosis and capillary dropout lead to a hypoxic inner retina, alterations in growth factors, and upregulation of inflammatory mediators. With disease progression, pathologic angiogenesis generates abnormal preretinal microvessels. Current therapies, which include panretinal photocoagulation and vitrectomy, have remained unaltered for several decades. With several exciting preclinical advances, emergent technologies and innovative cellular targets may offer newfound hope for developing "next-generation" interventional or preventive clinical approaches that will significantly advance current standards of care and clinical outcomes.