Ultrastructure of neurovascular changes in human diabetic retinopathy

作者：Feher Janos; Taurone Samanta; Spoletini Marialuisa^*; Biro Zsolt; Varsanyi Balazs; Scuderi Gianluca; Orlando Maria Patrizia; Turchetta Rosaria; Micera Alessandra; Artico Marco

来源：INTERNATIONAL JOURNAL OF IMMUNOPATHOLOGY AND PHARMACOLOGY, 2018, 31: UNSP 0394632017748841.

DOI：10.1177/0394632017748841

• basement membrane
• diabetic macular edema
• diabetic retinopathy
• glia
• proliferative diabetic retinopathy

The previous concept regarding diabetic retinopathy assigned a primary role to hyperglycemia-induced microvascular alterations, while neuronal and glial abnormalities were considered to be secondary to either ischemia or exudation. The aim of this study was to reveal the potential role of neuronal and glial cells in initial and advanced alterations of the retinopathy in human type 2 diabetes. Electron microscopy and histochemical studies were performed on 38 surgically removed human eyes (28 obtained from diabetic patients and 10 from non-diabetic patients). Morphometric analysis of basement membrane material and lipids was performed. An accumulation of metabolic by-products was found in the capillary wall with aging: this aspect was significantly more pronounced in diabetics. Muller glial cells were found to contribute to alterations of the capillary wall and to occlusion, as well as to the development of proliferative retinopathy and cystoid degeneration of the retina. Our results showed morphological evidence regarding the role of neuronal and glial cells in the pathology of diabetic retinopathy, prior and in addition to microangiopathy. These morphological findings support a neurovascular pathogenesis at the origin of diabetic retinopathy, thus the current treatment approach should be completed by neuroprotective measures.

• 出版日期2018-12