By Pierre Deligne; Institute for Advanced Study (Princeton, N.J.); et al
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An important normal physiological function of the retinal vasculature is maintenance of the inner blood-retinal barrier (iBRB), which prevents nonspecific permeation of the retinal neuropile by macromolecules yet facilitates exchange of respiratory gases, amino acids, salts, sugars and some peptides. Furthermore, retinal capillaries possess an array of abluminal anionic pumps contained within plasmolemmal caveolae [20] (Fig. 11) that assist the removal of excess fluid and waste products from the L V E A Fig.
Clinicopathological studies of diabetic retinopathy in which exact correlations were made between fluorescein angiograms and trypsin digest preparations have confirmed that regions of capillary acellularity corresponded to non-perfused microvasculature angiographically [5, 16, 19] often downstream from areas where microaneurysms were abundant (Fig. 31). One of the earliest abnormalities that predisposes to formation of microaneurysms during diabetic retinopathy is the loss of pericytes [33, 40, 41], and it is likely that localized increases in hydrostatic pressure could account for capillary wall stretching at weak points and subsequent microaneurysm formation [33].
Thirteen Mile Road, Royal Oak, MI 48073, USA Gabriele E. Lang, MD Department of Ophthalmology, University of Ulm Prittwitzstr. 43, 89075 Ulm, Germany Michael Larsen, MD, DMSc Department of Ophthalmology, Herlev Hospital University of Copenhagen, Copenhagen, Denmark Susan Lightman, FRCP, FRCOphth, PhD Department of Clinical Ophthalmology, Institute of Ophthalmology, Moorfields Eye Hospital London City Road, London, EC1V 2PD, UK Gerard A. Lutty, PhD The Wilmer Eye Institute, Johns Hopkins Hospital 600 N.
