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Klin Monbl Augenheilkd 2003; 220(8): 521-525
DOI: 10.1055/s-2003-41872
Übersicht
© Georg Thieme Verlag Stuttgart · New York

Entstehungsmechanismen des diabetischen Makulaödems

Pathogenesis of Diabetic Macular OedemaTim  U.  Krohne1 , Sascha  Fauser1 , Bernd  Kirchhof1 , Antonia  M.  Joussen1
  • 1Abteilung für Netzhaut- und Glaskörperchirurgie des Zentrums für Augenheilkunde und Zentrum für Molekulare Medizin (ZMMK), Universität zu Köln
Gefördert durch DFG Jo 324/4-1, Jo 324/6-1 (Emmy Noether), ZMMK Köln (TV76), Ernst und Berta Grimmke Stiftung und Gertrud und Werner Müller Stiftung
Further Information

Publication History

Eingegangen: 10. Juni 2003

Angenommen: 14. Juli 2003

Publication Date:
03 September 2003 (online)

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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.

Schlüsselwörter

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

Key words

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

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PD Dr. Antonia M. Joussen

Abteilung für Netzhaut- und Glaskörperchirurgie · Zentrum für Augenheilkunde

Joseph-Stelzmann-Straße 9

50931 Köln

Email: JoussenA@aol.com

URL: http://www.retina-cologne.de

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