What is the cause of microvascular obstructions of the retina

The thickness of the retinal basement membrane, activation and accumulation of leukocytes with local release of stimulatory factors and increase in adhesion molecules, comprise the basic aetiological factors. Furthermore, other factors that contribute are the proliferation of endothelial cells, alterations in red blood cells specific in DM (i.e., rigidity of red blood cell membrane, accumulation of red blood cells around macromolecules - fibrinogen and a2 globulin, and the difficulty of oxygen dissociation to the tissues, that is conversion of haemoglobin to oxyhaemoglobin), as well as the increased aggregability of platelets. The above factors, together with increased levels of PAI-1 (plasminogen activator inhibitor-1) and von Willebrand factor, create a hypercoagulable state, resulting in microvascular obstructions, hypoxia and anoxia.

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