Diabetic retinopathy is known as a microvascular complication of hyperglycemia, with a breakdown of the blood-retinal barrier, loss of pericytes, formation of microhemorrhages, early decreases in perfusion and areas of ischemia, with the latter speculated to induce the eventual proliferative, angiogenic phase of the disease. Our animal models of diabetic retinopathy demonstrate similar decreases in retinal blood flow as seen in the early stages of diabetes in humans. Our studies also show an alteration in the retinal distribution of red blood cells, with the deep capillary layer receiving a reduced fraction, and with flow being diverted more towards the superficial vascular layer. Normal red blood cell distribution is dependent on the presence of the endothelial surface layer, specifically the glycocalyx, which has been reported to be partially lost in the diabetic retina of both humans and animals. This review addresses these two phenomena in diabetes: altered perfusion patterns and loss of the glycocalyx, with a possible connection between the two.

中文翻译：

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糖尿病视网膜的血流分布和内皮表层。

糖尿病性视网膜病变被称为高血糖的微血管并发症，伴有血视网膜屏障破坏、周细胞丢失、微出血形成、早期灌注减少和局部缺血区域，推测后者会导致最终的增殖、血管生成阶段的疾病。我们的糖尿病视网膜病变动物模型显示出与人类糖尿病早期阶段相似的视网膜血流减少。我们的研究还表明红细胞在视网膜分布中发生了变化，深部毛细血管层接受的分数减少，并且血流更多地转向浅层血管层。正常的红细胞分布取决于内皮表面层的存在，特别是糖萼，据报道，它在人类和动物的糖尿病视网膜中部分丢失。这篇综述探讨了糖尿病中的这两种现象：灌注模式改变和糖萼丢失，两者之间可能存在联系。