Pathophysiological mechanisms of diabetic retinopathy

Abstract

Aim. To evaluate pathophysiological mechanisms in diabetic retinopathy.Material and methods. Factors of diabetic retinopathy pathogenesis, scientific reviews.Results. The evaluation of pathophysiological mechanisms in diabetic retinopathy found that early stages are characterized by histopathological changes, which include loss of pericytes, basement membrane thickening, haemodynamic alterations leading to reduced vascular integrity. The later stages of diabetic retinopathy are characterized by complications, which include visual impairment, primarily due to macular edema and proliferative diabetic retinopathy. Also, the severity of retinopathy was associated with poorer metabolic control, demonstrated by elevated HbA1c. Diabetic complications accompany the accumulation of advanced glycation end products in diabetic tissues. Increased accumulation of these products has been reported in epiretinal membranes by the use of the immunohistochemical technique. The binding of advanced glycation end products to a high-affinity receptor in pericytes exerts selective toxicity resulting in their death. Vascular endothelial growth factor exerts an important role in intraocular neovascularization due to ischemic retinopathy.Conclusions. Early stages of diabetic retinopathy are characterized by his topathological changes which include loss of pericytes, basement membrane thickening, haemodynamic alterations leading to reduced vascular integrity. The later stages of diabetic retinopathy are characterized by complications, which include visual impairment, primarily due to macular edema and proliferative diabetic retinopathy. The binding of advanced glycation end products to a high-affinity receptor in pericytes exerts selective toxicity resulting in their death.