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Die Veränderungen des Zellbesatzes der Netzhaut beim Diabetiker

Changed retinal cell content in diabetics

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Albrecht von Graefes Archiv für klinische und experimentelle Ophthalmologie Aims and scope Submit manuscript

Abstract

A quantitative exploration of retinal cell content was carried out in diabetics and metabolically healthy controls of the same age and sex distribution. After diabetes of 6 years duration there was a drastic diminution of cells in the ganglion cell layer of the central retinal area, while the number of cells of the inner nuclear layer was slightly reduced and that of the outer nuclear layer was still unchanged. The periphery of short duration diabetic retinae showed a normal cell content in all nuclear layers. In long-term diabetes (about 10 years), significant diminutions in cell numbers were found in all layers of both the retinal center and periphery. The described cell deficits are accounted for by disturbances of retinal microcirculation. After a relatively short duration of diabetes, blood flow interruptions in the area supplied by the central retinal artery occur; in long-term diabetics the chorioidal vessels are also affected. Connexions between the cell-deficit pattern and functional (electrophysiological) findings are discussed.

Zusammenfassung

Quantitative Untersuchungen des Zellbesatzes der Netzhaut von Diabetikern und Stoffwechselgesunden gleicher Alters- und Geschlechtsverteilung werden vorgelegt.

Bereits bei einer Diabetesdauer bis zu 6 Jahren finden sich im zentralen Netzhautbereich drastische Verminderungen der Zellzahlen in der Ganglienzellschicht. Zu diesem Zeitpunkt sind die Zellzahlen in der inneren Körnerschicht der zentralen Retina gering und in der äußeren Körnerschicht gar nicht vermindert. Die periphere Netzhaut von Diabetikern mit kurzer Krankheitsdauer weist einen unveränderten Zellbesatz aller Schichten auf.

Bei längerer Diabetesdauer (über 10 Jahre) finden sich signifikante Verminderungen der Zellzahlen in allen Schichten sowohl zentral als auch peripher.

Die beobachteten Zellausfälle werden auf Störungen der retinalen Mikrozirkulation zurückgeführt. Bei relativ geringer Diabetesdauer sind Störungen im Bereich der A. centralis retinae bekannt, bei Langzeitdiabetes wird auch die Choriocapillaris betroffen.

Es werden Zusammenhänge zwischen dem Muster der Zellausfälle und den funktionellen (elektroretinographischen) Befunden diskutiert.

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Authors and Affiliations

  1. Pathologisches Institut der KMU, Liebigstraße 26, DDR-7010, Leipzig, Deutsche Demokratische Republik

    U. Fuchs, H. Siwula & G. Taubert

  2. Carl-Ludwig-Institut für Physiologie, Deutschland

    A. Reichenbach

  3. Lehrstuhl für Medizinische Statistik, Dokumentation der Karl-Marx-Universität Leipzig, Deutschland

    P. Winiecki

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  1. U. Fuchs
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  2. A. Reichenbach
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  3. H. Siwula
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  4. G. Taubert
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  5. P. Winiecki
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Fuchs, U., Reichenbach, A., Siwula, H. et al. Die Veränderungen des Zellbesatzes der Netzhaut beim Diabetiker. Albrecht von Graefes Arch. Klin. Ophthalmol. 216, 245–251 (1981). https://doi.org/10.1007/BF00408166

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