Entstehungsmechanismen des diabetischen Makulaödems

Zusammenfassung

Hyperglykämie führt zu einer Schädigung der Blut-Retina-Schranke mit der Folge einer Ödembildung des Netzhautgewebes und dadurch bedingter Visusminderung. Für die Schrankenstörung sind drei Hauptmechanismen verantwortlich: die erhöhte parazelluläre Permeabilität des Gefäßendothels aufgrund veränderter Zell-Zell-Verbindungen, der Verlust der Endothelintegrität durch den Untergang von Endothelzellen und die Steigerung des transzellulären Transports durch die Endothelzellschicht. Diese Übersicht befasst sich mit den molekularen Grundlagen dieser Mechanismen und erläutert die Rolle von Zytokinen und zellulären Interaktionen bei der Schädigung der Blut-Retina-Schranke.

Abstract

Hyperglycaemia causes breakdown of the blood retina barrier leading to formation of macular oedema and consecutive visual loss. Three major mechanisms are involved in barrier breakdown: increased paracellular permeability of vascular endothelium due to disruption of cell junctions, loss of endothelial cell layer integrity due to cell destruction, and increased transcellular transport through the endothelium. This review focusses on the molecular basis of these mechanisms and discusses the role of cytokines and cellular interactions in blood retina barrier breakdown.

Diabetische Retinopathie - diabetische Makulopathie, Makulaödem - retinale Endothelzellen - Perizyten, Leukozyten - Hyperglykämie - VEGF - Angiopoietin - Wachstumsfaktoren

Diabetic retinopathy - diabetic maculopathy - macular oedema - retinal endothelial cells - pericytes - leukocytes - hyperglycaemia - VEGF - angiopoietin - growth factors

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