Diabetic retinopathy: Some cellular, molecular and therapeutic considerations

Any young ophthalmologist wishing to explore the scientific basis of ophthalmic disease could not adopt a better role model than William Bowman, who arguably was our most remarkable and pre-eminent clinician-scientist. In 1832, at the early age of 16 years, Bowman served as apprentice to the Birmingham surgeon Hodgson, with whom he developed his exceptional observational and recording skills. Later, as an anatomy demonstrator and medical student at King's College, London, he demonstrated his huge capacity for assembling, cataloguing and organising data, leading to the compilation of a comprehensive work on the anatomy and physiology of the body, a standard text at the time.1•2 Before long Bowman's insatiable appetite for discovery, coupled with the serendipitous acquisition of a new compound microscope, led him to explore the microanatomy of numerous human and vertebrate tissues and organs and indulge his passion for the meticulous and exact recording of his findings, often in breathtaking detail, given his tools at the time. He made many clinico-pathological correlations in diverse disease processes and elegantly documented, for the first time, structures in the eye and kidney which bear his name to this day. Bowman's ordered and disciplined approach to the analysis and documentation of his anatomical and pathological discoveries was matched only by a raft of innovations relating to the preservation and fixation of histological specimens which allowed him to survey the delicate and intricate tissues of the eye in unprecedented detail. He used the ' glycational' properties of syrup to stabilise and fixate the friable and unwieldy retina long before standard cross-linking techniques evolved and exploited agitational micro-dissection methods to separate the retinal microvascular from neural tissue more than a century in advance of trypsin digestion methods?