Pathology of Diabetic Retinopathy

Narrowed blood vessels Basement membrane thickening Damage to, & proliferation of endothelial cells Increased platelet aggregation
Ischemia Weakening of capillary walls, causing vessel wall out-pouching
  • The retinal response to ischemia is the release of vasogenic agents, including VEGF (vascular endothelial growth factor) which leads to neovascularization
  • The new vessels are fragile and prone to haemorrhage
  • Patients are left blind from tractional retinal detachment or rubeotic glaucoma
  • Breakdown of inner blood-retinal barrier Phosphorylation glycosylation & disorganisation of tight junctions Loss of pericytes
    Leaky retinal vessel walls Continual ischaemia causes IRMA formation & cotton wool spots