Diabetic retinopathy: current understanding, mechanisms, and treatment strategies

JCI Insight, Journal Year: 2017, Volume and Issue: 2(14)

Published: July 19, 2017

Diabetic retinopathy (DR) causes significant visual loss on a global scale. Treatments for the vision-threatening complications of diabetic macular edema (DME) and proliferative (PDR) have greatly improved over past decade. However, additional therapeutic options are needed that take into account pathology associated with vascular, glial, neuronal components retina. Recent work indicates diabetes markedly impacts retinal neurovascular unit its interdependent neuronal, immune cells. This knowledge is leading to identification new targets strategies preventing or reversing dysfunction, vascular leakage, ischemia, pathologic angiogenesis. These advances, together approaches embracing potential preventative regenerative medicine, could provide means better manage DR, including treatment at earlier stages more precise tailoring treatments based individual patient variations.

Language: Английский

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Diabetic Retinopathy Preferred Practice Pattern®

Ophthalmology, Journal Year: 2019, Volume and Issue: 127(1), P. P66 - P145

Published: Sept. 25, 2019

Language: Английский

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Diabetic retinopathy - ocular complications of diabetes mellitus

World Journal of Diabetes, Journal Year: 2015, Volume and Issue: 6(3), P. 489 - 489

Published: Jan. 1, 2015

In industrialized nations diabetic retinopathy is the most frequent microvascular complication of diabetes mellitus and common cause blindness in working-age population. next 15 years, number patients suffering from expected to increase significantly. By year 2030, about 440 million people age-group 20-79 years are estimated be worldwide (prevalence 7.7%), while 2010 there were 285 with 6.4%). This accounts for an by 20% developing countries 69% until 2030. Due rise patients, need ophthalmic care (i.e., exams treatments) will also represents a challenge eye-care providers. Development optimized screening programs, which respect available resources infrastructure, become even more important. Main reasons loss vision macular edema proliferative retinopathy. Incidence or progression these potentially blinding complications can greatly reduced adequate control blood glucose pressure levels. Additionally, regular mandatory detecting ocular initiating treatments such as laser photocoagulation case clinical significant early this way, risk considerably reduced. advanced stages retinopathy, pars-plana vitrectomy performed treat vitreous hemorrhage tractional retinal detachment. recent advent intravitreal medication has improved therapeutic options edema.

Language: Английский

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Retinal microglia: Just bystander or target for therapy?

Progress in Retinal and Eye Research, Journal Year: 2014, Volume and Issue: 45, P. 30 - 57

Published: Dec. 1, 2014

Language: Английский

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Neurodegeneration in diabetic retinopathy: does it really matter?

Diabetologia, Journal Year: 2018, Volume and Issue: 61(9), P. 1902 - 1912

Published: July 20, 2018

The concept of diabetic retinopathy as a microvascular disease has evolved, in that it is now considered more complex complication which neurodegeneration plays significant role. In this article we provide critical overview the role abnormalities and pathogenesis retinopathy. A special emphasis placed on pathophysiology neurovascular unit (NVU), including contributions neural elements. potential mechanisms linking retinal early impairment, effects neuroprotective drugs are summarised. Additionally, discuss how assessment could be an important index cognitive status, thus helping to identify individuals at risk dementia, will impact current procedures for diabetes management. We conclude glial, dysfunction interdependent essential development Despite intricate relationship, endpoint neuroprotection, itself, can therapeutic target, independently its disease. addition, interventional studies targeting pathogenic pathways NVU needed. Findings from these crucial, not only increasing our understanding retinopathy, but also help implement timely efficient personalised medicine approach treating complication.

Language: Английский

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New insights into the mechanisms of diabetic complications: role of lipids and lipid metabolism

Diabetologia, Journal Year: 2019, Volume and Issue: 62(9), P. 1539 - 1549

Published: July 25, 2019

Language: Английский

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Retinal oxygen: from animals to humans

Progress in Retinal and Eye Research, Journal Year: 2017, Volume and Issue: 58, P. 115 - 151

Published: Jan. 18, 2017

Language: Английский

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Diabetic retinopathy and diabetic macular oedema pathways and management: UK Consensus Working Group

Eye, Journal Year: 2020, Volume and Issue: 34(S1), P. 1 - 51

Published: June 1, 2020

Language: Английский

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Diabetic Macular Edema: Current Understanding, Molecular Mechanisms and Therapeutic Implications

Cells, Journal Year: 2022, Volume and Issue: 11(21), P. 3362 - 3362

Published: Oct. 25, 2022

Diabetic retinopathy (DR), with increasing incidence, is the major cause of vision loss and blindness worldwide in working-age adults. macular edema (DME) remains main impairment diabetic patients, its pathogenesis still not completely elucidated. Vascular endothelial growth factor (VEGF) plays a pivotal role DR DME. Currently, intravitreal injection anti-VEGF agents as first-line therapy DME treatment due to superior anatomic functional outcomes. However, some patients do respond satisfactorily injections. More than 30% exist persistent even after regular for at least 4 injections within 24 weeks, suggesting other pathogenic factors, beyond VEGF, might contribute Recent advances showed nearly all retinal cells are involved DME, including breakdown blood-retinal barrier (BRB), drainage dysfunction Müller glia pigment epithelium (RPE), involvement inflammation, oxidative stress, neurodegeneration, complicating The profound understanding changes proteomics metabolomics helps improve elucidation leads identification novel targets, biomarkers potential therapeutic strategies treatment. present review aimed summarize current molecular mechanisms, metabolomics, thus propose recommendations personalized

Language: Английский

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Targeted P2X7/NLRP3 signaling pathway against inflammation, apoptosis, and pyroptosis of retinal endothelial cells in diabetic retinopathy

Cell Death and Disease, Journal Year: 2022, Volume and Issue: 13(4)

Published: April 12, 2022

Abstract Retinal endothelial cells (RECs) are the primary target for diabetes-induced vascular damage. The P2X7/NLRP3 pathway plays an essential role in amplifying inflammation via ATP feedback loop, promoting inflammatory response, pyroptosis, and apoptosis of RECs early stages diabetic retinopathy induced by hyperglycemia inflammation. 3TC, a type nucleoside reverse transcriptase inhibitor, is effective against inflammation, as it can targeting formation P2X7 large pore formation. Hence, our aim was to evaluated anti-inflammatory effects potential mechanisms action 3TC vitro retinal microvascular treated with high-glucose (HG) lipopolysaccharide (LPS), well vivo retinas C57BL/6J male mice streptozotocin-induced diabetes. expression inflammasome-related proteins NLRP3, 3TC-treated were compared those untreated mice. Furthermore, anti-inflammatory, anti-apoptotic, anti-pyroptotic cultured cells. Co-application HG LPS significantly increased secretion IL-6, IL-1β, TNF-α, levels, whereas decreased cell apoptosis, pyroptosis. Inhibition P2X7R NLRP3 inflammasome activation inflammasome-mediated injury. prevented cytokine release following co-application LPS/BzATP. Our findings provide new insights regarding environment-induced injury, including

Language: Английский

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