Related Experiment Videos
Clinical choroidal thrombosis, hypertension, and diabetes mellitus: an electron microscopic study
S Takebayashi1, J Ogata, S Jimi
12nd Department of Pathology, School of Medicine, Fukuoka University, Japan.
Insights
Hypertension accelerates arteriosclerotic changes in choroidal arteries, particularly in smaller vessels. Diabetes mellitus did not significantly worsen these vascular changes, though hyaline deposits increased.
Area of Science:
- Ophthalmology
- Vascular Biology
- Pathology
Background:
- Choroidal artery changes are critical in ocular health.
- Hypertension and diabetes mellitus are major risk factors for vascular disease.
Purpose of the Study:
- To investigate pathological changes in choroidal arteries in patients with hypertension and diabetes mellitus.
- To determine the influence of these conditions on vascular morphology.
Main Methods:
- Autopsy examination of choroidal arteries from 16 Japanese patients.
- Histopathological analysis of arteriosclerotic changes, hyaline deposits, medial degeneration, and thrombotic events.
Main Results:
- Intimal thickening and medial damage correlated with aging and were accelerated by hypertension, especially in smaller arterioles.
- Diabetes mellitus did not enhance these vascular changes but increased subendothelial hyaline deposits.
- Thrombotic occlusion or narrowing of choroidal arteries was frequent in hypertensive and diabetic patients with renal insufficiency.
Conclusions:
- Hypertension is a primary driver of arteriosclerotic changes in choroidal arteries.
- While diabetes increased hyaline deposits, its impact on other vascular changes was less pronounced than hypertension.
- Obstructive choroidal artery changes may contribute to secondary damage in intraocular vessels and retinal tissues.
Abstract:
Changes in the choroidal artery were examined at autopsy in 16 Japanese patients with hypertension and insulin-dependent diabetes mellitus. These changes could be divided into 1) arteriosclerotic ones consisting of intimal thickening due to migration of smooth muscle cells, 2) hyaline deposits in the subendothelium, 3) extensive degeneration (moth-eaten atrophy and necrosis) of medial smooth muscle cells, and 4) changes resulting from fibrinoplatelet thrombi and their organization (recanalization and obstruction). The intimal thickening and medial damage correlated with aging, were accelerated by hypertension, and were remarkable in arterioles less than 60 micron in diameter. Diabetes mellitus apparently did not enhance these vascular changes. Thrombotic occlusion or narrowing of the choroidal artery was frequently observed in the arterioles of patients with hypertension and diabetes mellitus who had chronic azotemia or renal insufficiency. Subendothelial hyaline deposits were increased in patients with diabetes. The narrowing or obstructive changes in the choroidal artery were extensive in the intraocular blood vessels. These changes may be secondary and induce damage to other intraocular blood vessels and tissues, including the retina.