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Pathomechanismen der diabetischen Retinopathie

Pathomechanisms of diabetic retinopathy

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Der Diabetologe Aims and scope

Zusammenfassung

Die Entstehung der diabetischen Retinopathie hängt eng mit der Störung der inneren Blut-Retina-Schranke zusammen. Gleichzeitig werden Schädigungsmechanismen der Neurodegeneration beobachtet, die über Gliazellen vermittelt und bei bisherigen Einteilungen der diabetischen Retinopathie nur unzureichend berücksichtigt werden. Bezüglich der Pathophysiologie der diabetischen Retinopathie wurden inzwischen viele Erkenntnisse, v. a. aus Tiermodellen, histologischen Studien oder Messungen von Zytokinen im Kammerwasser und im Glaskörper von Menschen mit Diabetes, gewonnen. Therapeutische Konsequenzen haben sich aber bisher insbesondere aus dem Wissen über die Pathogenese der mikrovaskulären Veränderungen abgeleitet, indem der permeabilitätssteigernde „vascular endothelial growth factor“ gehemmt wird oder entzündungshemmende Steroide genutzt werden.

Abstract

The pathogenesis of diabetic retinopathy (DR) is closely linked to disruption of the inner blood-retinal barrier; however, there is also an ongoing process of inflammation-driven neurodegeneration from the beginning, triggered by glial cell activity but insufficiently taken into consideration for previous classifications of DR. With respect to the pathophysiology of DR, profound knowledge has been gained from animal models, histopathological studies of human tissue and the biochemical analysis of cytokines in samples from the anterior chamber and vitreous body; however, so far only insights into the microvascular changes and mainly those driven by angiogenic factors, such as vascular endothelial growth factor (VEGF), are reflected in therapeutic approaches as are the pleiotropic actions triggered by local steroids.

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Authors and Affiliations

  1. Klinik für Augenheilkunde, Medizinische Fakultät, Universitätsklinikum Freiburg, Killianstr.5, 79106, Freiburg, Deutschland

    Hansjürgen Agostini & Gottfried Martin

  2. Department für Augenheilkunde, Universität Tübingen, Tübingen, Deutschland

    Focke Ziemssen

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  1. Hansjürgen Agostini
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  2. Gottfried Martin
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Correspondence to Hansjürgen Agostini.

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H. Agostini, G. Martin und F. Ziemssen geben an, dass kein Interessenkonflikt besteht.

Dieser Beitrag beinhaltet keine von den Autoren durchgeführten Studien an Menschen oder Tieren.

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Agostini, H., Martin, G. & Ziemssen, F. Pathomechanismen der diabetischen Retinopathie. Diabetologe 14, 542–549 (2018). https://doi.org/10.1007/s11428-018-0409-9

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