OMD, le VEGF et les produits terminaux avancés de glycation devraient, selon les prédictions, réguler à la hausse le niveau des molécules d’adhérence intercellulaire (ICAM-1) ce qui, à son tour, augmente la leucostase dans les vaisseaux rétiniens, accroît la perméabilité vasculaire et diminue la perfusion capillaire.
Vascular endothelial growth factor (VEGF), a cytokine released by the retinal vascular cells, is thought to govern vascular permeability in response to hyperglycemia and also initiate angiogenesis in response to hypoxia. In terms of DME, VEGF and advanced glycation end-products are proposed to up-regulate the level of intercellular adhesion molecules (ICAM-1) and, in turn, this results in an increased level of leukostasis in the retinal vessels, increased vascular permeability and loss of capillary perfusion.