A 55-year-old woman comes to the physician because of increased blurring of vision in both eyes for the past 4 months. She has tried using over-the-counter reading glasses, but they have not helped. She has a history of hypertension, type 2 diabetes mellitus, and chronic obstructive pulmonary disease. Current medications include lisinopril, insulin, metformin, and a fluticasone-vilanterol inhaler. Vital signs are within normal limits. Examination shows visual acuity of 20/70 in each eye. A photograph of the fundoscopic examination of the right eye shows scattered retinal microaneurysms, and new blood vessel formation. Which of the following contributed most to the pathogenesis of this patient's current ocular condition?

Question

Quizplus · Accepted Answer

Eductional Objective: Proliferative diabetic retinopathy develops because chronic hyperglycemia results in the death of retinal microvascular cells and capillary dysfunction, with subsequent ischemia. Dying cells release vascular endothelial growth factor (VEGF), which promotes the growth of new fragile blood vessels (neovascularization) that hemorrhage easily and interfere with the transmission of light.

A 55-Year-Old Woman Comes to the Physician Because of Increased