国际眼科纵览 ›› 2023, Vol. 47 ›› Issue (4): 322-327.doi: 10.3760/ cma.j.issn.1673-5803.2023.04.006

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糖尿病性白内障晶状体前囊膜的病理改变

 谢伊 管怀进 季敏   

  1. 南通大学附属医院眼科 南通大学医学院,江苏南通 226001
  • 收稿日期:2023-01-15 出版日期:2023-08-22 发布日期:2023-08-22
  • 通讯作者: 季敏, Email:amyji1234@hotmail.com
  • 基金资助:
    国家自然科学基金(81770906、81974129、82171038);江苏省卫生健康委科研项目(M2021084)

Pathological changes in the anterior capsule of diabetic cataract

Xie Yi, Guan Huaijin, Ji Min    

  1. Eye Institute, Affiliated Hospital of Nantong University, Medical School of Nantong University, Nantong Jiangsu 226001, China
  • Received:2023-01-15 Online:2023-08-22 Published:2023-08-22
  • Contact: Ji Min, Email:amyji1234@hotmail.com
  • Supported by:
    National Natural Science Foundation of China (81770906, 81974129, 82171038);Scientific Research Project of Jiangsu Commission of Health(M2021084)

摘要: 糖尿病性白内障是由糖尿病(diabetes mellitus,DM)引起或加重的眼部并发症之一,其发病机制尚未完全阐明。晶状体囊膜是由晶状体上皮细胞分泌的一种无细胞、透明、光滑的基底膜,起着屏障作用。高血糖状态下,晶状体囊膜通透性改变会导致一系列病理改变,主要包括前囊膜纤维化、上皮细胞与囊膜间出现空隙等组织结构异常;前囊膜呈复层结构、指状突起、板层分离等超微结构异常以及基底膜相关分子表达异常,进而导致晶状体内部稳态失衡,加快白内障的发生。目前针对糖尿病晶状体前囊膜改变的研究也在逐步推进,这有助于从不同的角度重新思考糖尿病性白内障的发生机制,为诊断和防治提供病理学基础。(国际眼科纵览,2023, 47:322-327)

关键词: 糖尿病性白内障, 前囊膜, 病理, 超微结构, 分子病理

Abstract: Diabetic cataract is one of the ocular complications caused or aggravated by diabetes mellitus (DM), its pathogenesis has not been elaborated completely. The lens capsule is an acellular, transparent, smooth basement membrane which acts as a barrier secreted by the lens epithelial cells. In hyperglycaemic states, the permeability of lens capsule membrane is altered and a series of pathological changes occur including: histological abnormalities such as fibrosis of anterior lens capsule, loss of intercellular junctions and gaps between epithelial cells and capsule membrane, ultrastructural abnormalities such as epithelial complex structure, gap laxity, finger-like protrusions and lamellar separation, as well as abnormal expression of basement membrane-related molecules. The balance of internal homeostasis of the lens will then accelerate the development of cataracts. Progress of researches on diabetic anterior lens capsule changes help to rethink the mechanism of diabetic cataract from a different perspective and provide a pathological basis for diagnosis and prevention. (Int Rev Ophthalmol, 2023, 47: 322-327)

Key words: diabetic cataract, anterior lens capsule, pathology, ultrastructure, molecular pathology