VWF and diabetes mellitus: Activated platelets adhere to the damaged vessel wall through the bridging effect of vWF, directly affecting the formation of thrombus.[21] It has also been reported that there is a significant correlation between decreased retinal blood circulation and the degree of increased vWF.[22] Significantly elevated vWF levels have been detected in retinal tissues of patients with early diabetes mellitus, accompanied by reduced retinal blood flow and even slowed circulation, further causing ischemia and hypoxia in fundus-related tissues and possibly further aggravating the progression of DR.