New insights into the pathogenesis of diabetic retinopathy--hormonal rather than metabolic factors are important.
Diabetic retinopathy has traditionally been viewed as a metabolite-driven, occlusive vasculopathy that affects both retinal microvascular haemodynamics and stricture; analogies to cholesterol-driven occlusive atherosclerosis of the macrovascular circulation were drawn. However this paradigm may no longer be appropriate. Recent evidence suggests that diabetic retinopathy from the beginning is the consequence of a complex hormonal dysfunction, which is related to insulin-dependent up- and downregulation of growth factors, to which metabolic, haemodynamic, endocrine, paracrine, and autocrine mechanisms contribute.
Chantelau
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E
Diabetes Outpatient Clinic, Department of Endocrinology, Diabetes and Rheumatology, Heinrich Heine University of Düsseldorf, Germany. lobnig@med.uni-duesseldorf.de
Volaco
A
A
Meyer-Schwickerath
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R
D000818:Animals; D002986:Clinical Trials as Topic; D003930:Diabetic Retinopathy / Q000145:classification / Q000209:etiology* / Q000378:metabolism* / Q000628:therapy; D019317:Evidence-Based Medicine; D006133:Growth Substances / Q000378:metabolism*; D006728:Hormones / Q000378:metabolism*; D006801:Humans; D007328:Insulin / Q000378:metabolism; D008659:Metabolic Diseases / Q000150:complications* / Q000378:metabolism*; D008954:Models, Biological
D006133:Growth Substances; D006728:Hormones; D007328:Insulin