Contemporary Opinion on the Occurrence of Diabetic Retinopathy

Overview

The basic pathogenic mechanism of the diabetic retinopathy is hyperglycaemia. Capillary damage could beexplained by several mechanisms. Among many causes the sorbitol overload, the excessive storage of advancedglycosylation endproducts, oxidative stress and/or the cell apoptosis after the paradoxical glucose starvation can beemphasised. The article further analyses mechanism of capillary damage in the retina is on the basis of hemorheological,hemodynamical and histopathological changes. The specific role of the retinal pigment epithelium isdescribed. Histopathological changes accompanying the elementary microcirculatory anomalies result from theapoptotic death of pericytes, damage of endothelial cells, and impairment of the basal membrane. Microcirculatorychanges, which include the capillary dilation, vascular occlusion, and proliferation of new vessels, bring about furtherdevelopment of the diabetic retinopathy.

Key words:
pathophysiology, diabetic retinopathy, hyperglycaemia, pericytes, endothelial cells.