Changes in the diabetic choroidal vasculature: scanning electron microscopy findings

Area of Science:

• Ophthalmology
• Diabetic Retinopathy Research
• Vascular Biology

Background:

• Diabetes mellitus type I can lead to microvascular complications affecting various organs.
• Ocular microvasculature, particularly choroidal vessels, may be susceptible to diabetic damage.
• Understanding these changes is crucial for managing diabetic eye disease.

Purpose of the Study:

• To investigate the morphological alterations in choroidal vasculature in human cadaver eyes from patients with diabetes mellitus type I using scanning electron microscopy (SEM).
• To document novel SEM findings in the choroidal vessels associated with long-standing diabetes.

Main Methods:

• Scanning electron microscopy (SEM) was employed to examine vascular casts.
• Vascular casts were prepared from 20 human cadaver eyes of patients diagnosed with diabetes mellitus type I.
• A previously established technique was utilized for vascular casting.

Main Results:

• SEM analysis revealed increased tortuosity and irregular lumen diameters (dilation and narrowing) in choroidal vessels.
• Evidence of hypercellularity, vascular loop formation, and microaneurysms was observed.
• Significant findings included the "drop-out" of choriocapillaries and the formation of sinus-like structures between choroidal lobules.

Conclusions:

• This study presents the first SEM investigation of vascular casts from human diabetic eyes, detailing specific microvascular pathologies.
• The observed vascular changes in the choroid underscore the severe impact of diabetes mellitus type I on ocular vasculature.
• These findings contribute to the understanding of diabetic-induced vascular remodeling in the eye.