Disturbed platelet aggregation as a factor of diabetic maculopathy and diabetic macular edema in patients with nonproliferative diabetic retinopathy in type 2 diabetes mellitus

S.Yu. Mogilevskyy, Yu.O. Panchenko, S.V. Ziablitsev, L.V. Natrus


Background. The analysis of current data makes it possible to suggest that the pathogenetic factors of diabetes mellitus (DM) can provoke the proaggregant status of platelets and cause microcirculatory disturbances in the eye membranes and the development of diabetic maculopathy (DMP) and diabetic macular edema (DMA). The purpose of the study is to analyze the disturbed platelet aggregation in DMA and DMP in nonproliferative diabetic retinopathy (NPDR) with type 2 DM. Materials and methods. The study included 32 patients (32 eyes) with type 2 DM, in whom mild (14 patients, 14 eyes) and moderate (18 patients, 18 eyes) stages of NPDR were detected according to the Early Treatment Diabetic Retinopathy Study classification. Adenosine diphosphate, adrenaline, angiotensin-2 (Ang-2), platelet-activating factor (PAF), and collagen were used to study platelets in vitro. Platelet aggregation was evaluated using turbidimetric method on Chronolog analyzer (USA). Results. Patients with DMP in moderate NPDR showed greater reactivity of platelets to Ang-2, PAF, and adrenaline than with the mild stage (p < 0.01). This phenomenon reflected an increase in platelet aggregation due to violations of sympathoadrenal and renin-angiotensin systems and an increase in the severity of inflammation. Platelet hyperreactivity to Ang-2 was the cause of DMA in patients with DMP at moderate stage of NPDR. Conclusions. Pathogenetic factors of DM can provoke proaggregant status of platelets and, thus, cause microcirculatory disturbances in the eye membranes, which is accompanied by the development of DMP and DMA.


diabetic maculopathy; diabetic macular edema; nonproliferative diabetic retinopathy; platelet aggregation


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