diabetic retinopathy

出典: meddic

糖尿病性網膜症, DR

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア(Wikipedia)』「2014/12/03 10:44:45」(JST)

wiki en

[Wiki en表示]

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

英文文献

  • Interleukin-18 has antipermeablity and antiangiogenic activities in the eye: reciprocal suppression with VEGF.
  • Shen J1, Choy DF, Yoshida T, Iwase T, Hafiz G, Xie B, Hackett SF, Arron JR, Campochiaro PA.Author information 1Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland; Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland.AbstractInterleukin-18 (IL-18) is increased along with IL-1β by activation of the inflammasome and has been implicated in inflammatory and autoimmune diseases, but its role in the eye is uncertain. In patients with macular edema due to retinal vein occlusion, intraocular IL-18 levels increased significantly (P < 0.001) after treatment with ranibizumab particularly in patients with high baseline IL-18 which correlated with good visual outcome (P < 0.05). In mice with ischemic retinopathy, suppression of VEGF caused an increase in IL18 mRNA due to an increase in IL-18-positive myeloid cells. VEGF significantly and specifically inhibited IL-18 production by myeloid cells stimulated with lipopolysaccharide (P < 0.001). Intraocular injection of IL-18 reduced VEGF-induced leakage and neovascularization, and reversed VEGF-induced suppression of Claudin5 expression and Claudin 5 labeling of vascular tight junctions. Injection of IL-18 also increased expression of Thrombospondin 1 and reduced ischemia-induced retinal neovascularization relevant to diabetic retinopathy and subretinal neovascularization relevant to neovascular age-related macular degeneration. Thus, VEGF and IL-18 suppress each other's production and effects on the vasculature suggesting that IL-18 may provide benefit in multiple retinal/choroidal vascular diseases. J. Cell. Physiol. 229: 974-983, 2014. © 2013 Wiley Periodicals, Inc.
  • Journal of cellular physiology.J Cell Physiol.2014 Aug;229(8):974-83. doi: 10.1002/jcp.24575.
  • Interleukin-18 (IL-18) is increased along with IL-1β by activation of the inflammasome and has been implicated in inflammatory and autoimmune diseases, but its role in the eye is uncertain. In patients with macular edema due to retinal vein occlusion, intraocular IL-18 levels increased significantl
  • PMID 24515951
  • Altered expression of mitofusin 2 in penile tissues of diabetic rats.
  • Yang J1, Wang T, Zhang Y, Li R, Wang S, Xu H, Liu J, Ye Z.Author information 1Department of Urology, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, Hubei, China.AbstractDiabetic erectile dysfunction (ED) is a common complication in diabetes mellitus, and the efficacy of first-line therapies is not satisfactory. Recent studies revealed that corporal apoptosis was responsible for the nonresponsiveness of severe ED to phosphodiesterase type 5 inhibitors. Mitofusin 2 (Mfn2) is a versatile protein, regulating mitochondrial morphology and playing an important role in apoptosis. Several studies showed that expression of Mfn2 was decreased in STZ-induced diabetic rats' kidney, myocardium and retina, which was associated with diabetic nephropathy, cardiomyopathy and retinopathy respectively. In this study, our aim was to explore the expression of Mfn2 and apoptosis in diabetic rats' penes. We found that erectile function (ICP/MAP) elicited by electrical stimulation of cavernous nerve was markedly impaired in diabetic rats compared with the normal rats. The mRNA and protein levels of Mfn2 were found to be significantly reduced in diabetic rats' penile tissues. Compared with normal rats, the content of smooth muscle and B-cell lymphoma 2 (Bcl-2)/Bcl-2-associated X protein (Bax) ratio were dramatically decreased, and penile apoptotic index and expression of activated-caspase-3 were dramatically increased in diabetic rats. This data indicated that repression of Mfn2 in diabetic rats' penes might be associated with excessive apoptosis in diabetes-induced severe ED.
  • Andrologia.Andrologia.2014 Jun;46(5):522-8. doi: 10.1111/and.12108. Epub 2013 May 19.
  • Diabetic erectile dysfunction (ED) is a common complication in diabetes mellitus, and the efficacy of first-line therapies is not satisfactory. Recent studies revealed that corporal apoptosis was responsible for the nonresponsiveness of severe ED to phosphodiesterase type 5 inhibitors. Mitofusin 2 (
  • PMID 23682852
  • Aqueous humour levels of placental growth factor in diabetic retinopathy.
  • Ando R1, Noda K, Namba S, Saito W, Kanda A, Ishida S.
  • Acta ophthalmologica.Acta Ophthalmol.2014 May;92(3):e245-6. doi: 10.1111/aos.12251. Epub 2013 Aug 3.
  • PMID 23910830

和文文献

  • Relationship between Functional and Structural Changes in Diabetic Vessels in Optical Coherence Tomography Angiography.
  • 眼科単科病院を受診する糖尿病患者の網膜症に対する説明
  • 増殖糖尿病網膜症に続発する血管新生緑内障に対する毛様体扁平部バルベルト緑内障インプラントの初期成績 (第20回日本糖尿病眼学会)

関連リンク

National Eye Institute, NIH, is dedicated to vision research that saves sight & reduces visual impairment & blindness. ... Who is at risk for diabetic retinopathy? All people with diabetes–both type 1 and type 2–are at risk. That’s why ...
Diabetic retinopathy is one of the largest causes of visual loss worldwide and is the principal cause of impaired vision in patients between 25 and 74 years of age. The prevalence of diabetic retinopathy increases with duration of ...

関連画像

diabetic retinopathy NVD.jpg (232676 bytes Digital Retinography – Diabetes vessels of the retina diabetic retinopathy Diabetic RetinopathyDiabetic retinopathyDiabetic retinopathy


★リンクテーブル★
リンク元糖尿病網膜症」「ロス斑」「DR」「糖尿病性網膜症
拡張検索preproliferative diabetic retinopathy」「proliferative diabetic retinopathy」「simple diabetic retinopathy
関連記事diabetic」「retinopathy

糖尿病網膜症」

  [★]

diabetic retinopathy, DR
retinopathia diabetica
糖尿病性網膜症
糖尿病福田分類
[show details]


疫学

  • 糖尿病の有病率は740万人(2002年の厚生労働省統計)で、糖尿病網膜症はその30-50%が罹患している。
  • 罹病期間が10年以上の糖尿病患者の約50%が何らかの網膜症を有し、全糖尿病患者の少なくとも1%が失明。
  • 糖尿病性網膜症は、未治療で経過した場合、7年で50%、20年以上で90%以上が発症する。25年以上では網膜症を有する患者の25%が増殖網膜症となる。

遺伝形式

病変形成&病理 SOP.138

  • 細小血管 = 内皮細胞 + 基底膜 + 周皮細胞
  • 糖尿病により細小血管が傷害される。
  • 1. 基底膜の肥厚と周皮細胞の消失 → 周皮細胞の消失により血管壁は薄くなり、脆弱化が進行する。
  • 2. 内皮細胞の増殖 → これにより毛細血管瘤が形成
  • 3. 2.がみられるころに、血管網膜関門の破綻により硬性白斑が形成される
  • 4. 1-3.により血流障害、血栓形成をきたし血管床閉塞を生じる

病理変化

分類

眼底所見による分類

SOP.138-139
  • 1. 単純網膜症 :血管症の初期病変
[show details]
  • 2. 前増殖網膜症:病変が進行し毛細血管の閉塞が進行している状態
  • 新生血管:毛細血管の閉塞に続発した虚血性変化。最初は網膜内で発育。
  • 軟性白斑(綿花様白斑):毛細血管の閉塞に続発した虚血性変化。神経線維層の梗塞。網膜神経線維の虚血による軸索の膨化(CBT QB vol2 p.495)。網膜表層は白色の混濁を呈し、境界は硬性白斑よりも不鮮明。
  • 火焔状網膜出血、静脈異常、網膜内細小血管異常(IRMA)。(出典不明)
  • 3. 増殖網膜症 :血管床の閉塞が拡大し網膜虚血が進行し、網膜硝子体に血管新生を発症したもの
  • 新生血管増殖:網膜内から内境界膜を貫き、網膜表面~硝子体に向かって成長していく
  • 硝子体出血:新生血管により網膜と後部硝子体膜とが癒着し、この状態で硝子体剥離が生じると、新生血管が牽引され破綻する。
  • 増殖膜の形成:
  • 牽引性の網膜剥離:硝子体剥離だけでなく、網膜を剥離して牽引性の網膜剥離を生じる。
  • 網膜前出血。(出典不明)

David分類

DMR.200
  • 1. 単純糖尿病網膜症 :毛細血管瘤、点状・斑状出血、火焔状出血、少数の軟性白斑
  • 2. 増殖前糖尿病網膜症:多発する軟性白斑、網膜内細小血管異常、静脈異常、無灌流域
  • 3. 増殖糖尿病網膜症 :新生血管、硝子体出血、線維血管性増殖組織、牽引性網膜剥離 ← 網膜の中ではなく、網膜上の新生血管

参考

  • 1.
[display]http://www.nmckk.jp/pdf/thesis/JJCD/024/007/JJCD_024_007_1051.pdf

国試


ロス斑」

  [★]

Roth spot, Roth spots, Roth's spots
Roth斑

概念

  • ロス斑は白斑を中心と中心とする出血像を示す。ロス斑は綿花状白斑の周りを出血が取り囲んでいる。綿花用白斑は虚血に陥った軸索の膨化(破裂?, bursting)により生じている。毛細血管に入る前の細動脈が虚血により破裂することにより生じている。多くの病態でロス斑が起こるのであって、細菌性心内膜炎に特異的なわけではない。(参考(1))

原因

参考3

参考

  • 1.
[display]http://www.kellogg.umich.edu/theeyeshaveit/optic-fundus/roth-spot.html
  • 2.
http://www.nejm.org/doi/full/10.1056/NEJMicm040783
  • 3. Roland Ling, Bruce James White-centred retinal haemorrhages(Roth spots). Postgrad Med Ja 1998;74:581-582
[display]http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2361020/pdf/postmedj00094-0007.pdf
  • 4
http://www.uveitis.org/medical/articles/case/Uveitis-%20Roth%20Spots.pdf
  • 5.写真
[display]http://www.kellogg.umich.edu/theeyeshaveit/optic-fundus/images/roth-spot.jpg


DR」

  [★]

糖尿病性網膜症」

  [★] 糖尿病網膜症, diabetic retinopathy, DR

preproliferative diabetic retinopathy」

  [★] 前増殖糖尿病網膜症, PPDR


proliferative diabetic retinopathy」

  [★] 増殖糖尿病網膜症 PDR


simple diabetic retinopathy」

  [★] 単純糖尿病網膜症, SDR

diabetic」

  [★]

  • adj.
  • 糖尿病性の、糖尿病の
  • n.
diabetesdiabetes mellitusdiabetic patientdiabetic subjectDM

WordNet   license wordnet

「suffering from diabetes」

WordNet   license wordnet

「someone who has diabetes」

PrepTutorEJDIC   license prepejdic

「糖尿病の / 糖尿病患者」

WordNet   license wordnet

「of or relating to or causing diabetes」

retinopathy」

  [★] 網膜症

WordNet   license wordnet

「a disease of the retina that can result in loss of vision」




★コメント★

[メモ入力エリア]
※コメント5000文字まで
ニックネーム:
コメント:




表示
個人用ツール


  meddic.jp

リンク
連絡