Diabetik Retinopati ve Etiyopatogenezi

Year 2014, Volume: 15 Issue: 2, 207 - 217, 01.08.2014

Sibel İnan

Abstract

Chronic hyperglycemia is one of the most important factors for the formation and progression of diabetic retinopathy (DR). Insulin resistance and hyperinsulinemia, altered fatty acid and protein metabolism, osmotic effect, hypertension, impaired metabolic sympathetic activation are other important risk factors. Oxidative stress also increases in diabetes, but exact contribution of related mechanisms to diabetic complications has not been fully verified. Platelet derived growth factor (PDGF) that take place in the pathogenesis of DR together with vascular endothelial growth factor (VEGF) produces angiogenesis in microvascular structures by stimulating migration and proliferation of RPE and glial cells

Keywords

Diabetic retinopathy; etiology; pathogenesis

Diabetik Retinopati ve Etiyopatogenezi

Abstract

Kronik hiperglisemi, diyabetik retinopati (DR) oluşumu ve ilerlemesinde en önemli etkenlerden biridir. Diğer risk faktörleri içinde; insülin direnci ve hiperinsülinemi, değişmiş olan yağ asidi ve protein metabolizması, ozmotik etki, hipertansiyon, bozulmuş metabolik sempatik aktivasyon sayılabilir. Diyabette oksidatif stres de artabilmektedir, ancak ilgili mekanizmaların diabetik komplikasyonlara katkısı tam olarak ispatlanmış değildir. Vasküler endotelyal büyüme faktörü (VEGF) ile birlikte DR patogenezinde rol oynayan platelet kaynaklı büyüme faktörü (PDGF), retina pigment epitel hücresi ve glial hücre göçü ve proliferasyonunu uyararak mikrovasküler yapıda anjiogenezis yapar

Keywords

Diabetik retinopati, etyoloji, patogenez

References

• Büyükdevrim S. Iç Hastalıkları. Diabetes mellitus. 1inci Baskı, İstanbul: Bayda AŞ, 1992:190-1.
• Expert committee on the diagnosis and classifica- tion of diabetes mellitus. Report of expert committee on diagnosis and classification of diabetes mellitus. Diabetes Care 2003;26(suppl 1):5-20.
• Özçetin H. Pratik göz hastalıkları. 2nci Baskı, Bursa: F. Özsan Matbaacılık Ltd Şti, 2000:111-2.
• Klein R, Klein BE, Moss SE, Cruickshanks KJ. The Wisconsin epidemiologic study of diabetic retinopa- thy. XIV Ten-year incidence and progression of dia- betic 1994;112(9):1217-28. Arch Ophthalmol
• Bresnick GH. Diabetic macular edema, a review. Ophthalmology 1986;93(7):989-97
• Klein R, Klein B, Moss S. Epidemiology of prolifera- tive retinopathy. 1992;15(12):1875-91. Diabetes Care
• Günalp I. Diabetik retinopatide son gelişmeler. T Klin Oftalmoloji 1993;2(1):1-2.
• Bayraktar Z. Diabetik retinopatinin sınıflandırılması, erken tanı ve takibi. T Oft Gaz 1990;20(2):136-9.
• ETDRS Report Number 10. Grading diabetic reti- nopathy from stereoscopic color fundus photographs. An extension of the modified Airlie House classifica- tion. Ophthalmology 1991;98(5 suppl):786-806.
• Guyer D, Yanuzzi L, Shields J (Editor). Retina- vitreous- macula. In: Aiello L, Cavallerano D, Aiello A, Bursell S. Diabetic retinopathy. WB Saunders Co, 1999:316-29.
• Cogan DG, Toussaint D, Kuwabara T. Retinal vas- cular patterns, diabetic retinopathy. Arch Ophthalmol 1961;66(3):366-78.
• Friendwald JS. Diabetic retinopathy. Am J Ophthalmol 1950;33(8):1199.
• Engerman RL. Pathogenesis of diabetic retinopa- thy. Diabetes 1989;38(10):1203-6.
• Muraoka K, Shimizu K. Intraretinal neovasculariza- tion 1989;91(12):1440-6. retinopathy. Ophthalmology
• Patz A. Clinical and experimental studies on reti- nal 1982;94(6):715-43. Am J Ophthalmol
• Ryan S(Editor). Retina. In: Davis MA. Proliferative diabetic retinopathy. St Louis: CV Mosby CO, 1989;367-402.
• Conway MD, Olk RJ . Diabetic maculopathies. Diagnosis and treatment. Ophthalmol Clin North Am 1993;(6):213-30.
• Frank NR. On the pathogenesis of diabetic reti- nopathy. Ophthalmology 1991;98(5):586-93.
• Grant M, Russel B, Fitzgerald C, et al. Insulin-like growth factors in vitreous: studies in control and diabetic subjects with neovascularization. Diabetes 1986;35(4):416-20.
• Nakazawa H, Genka C, Fujishima M. Pathological aspect of active oxygen/free radicals. Japan J Physiol 1996;46(1):15-32.
• Maritim AC, Sanders RA, Watkins JB. Diabetes, oxidative stress and antioxidants: a review. J Biochem Mol Toxicol 2003;17(1):24-38.
• Dandona P, Thusu K, Cook S, et al. Oxidative dam- age to DNA 1996;347(8999):444-5.
• Schmetterer L, Wolzt M. Ocular blood flow and associated functional deviations in diabetic retinopa- thy. Review. Diabetologia 1999;42(4):387-405.
• Jochen S, Klaus TP, Helmut S, Andreas P. High levels of anjiostatin in the vitreous of patients with proliferative diabetic retinopathy after previous laser coagulation. Diabetes 1999;48(suppl 1):A20.
• Rafael S, Rosa B, Ana C, Cristina H, Rosa M S, Jordi M. Lack of relationship between increased IGF-1 and VEGF intravitreous concentrations in proliferative diabetic 1):A156-7. Diabetes 1999;48(suppl
• Aly A, Gamal AB, Soheir S, Ahmed AM. Serum growth hormone (GH) insülin like growth factor one (IGF-1) and insülin growth factor binding protein three (IBGFBP3) in diabetic retinopathy. Diabetes 1999;48(suppl 1):A386.