Diabetic retinopathy: a review

Abstract

Diabetic retinopathy is a progressive disease elicited by chronic exposure to high blood glucose, e.g., hyperglycemia and is generally recognized as a vascular disease like other diabetesrelated diseases. Although the pathogenesis of diabetic retinopathy has not been clearly elucidated, numerous drugs have been developed based on the current understanding of the complicated and intricate biochemical and pathophysiological aspects of the disease. Current therapy for diabetic retinopathy includes laser photocoagulation, surgery, and metabolic control. Future therapies for diabetic retinopathy are based on the pathophysiology of the disease, such as anti-VEGF, anti-angiogenesis, and anti-inflammatory and anti-extracellular matrix pathways. Several clinical trials are ongoing for diabetic macular edema using drug delivery routes including intravitreal injections, subtenon injections and intravenous injection, topical drops, and intravitreal implants. Drug Dev Res 69:1-14, 2008.

Nε-(Carboxymethyl)Lysine-Induced Choroidal Angiogenic Potential Facilitates Retinal Neovascularization in Advanced-Diabetic Rat In Vitro

“…New microvessels are sometimes accompanied by a fibrovascular ridge extending into the vitreous cavity or along the surface of the retina [26]. In the proliferative diabetic retinopathy, the action of VEGF is upregulated and promotes blood retinal barrier breakdown and neovascularization to produce diabetic macular edema [9].…”

Early interventions to prevent retinal vasculopathy in diabetes: a review

“…13 Several interdependent metabolic mechanisms have been implicated through which hyperglycemia has an effect on vascular endothelium. These mechanisms include activation of protein kinase C, 14 increased polyol, 15 oxidative stress, 16 up-regulation of vascular endothelial growth factors (VEGF), 17 creation of advanced glycation end products, 18 activation of the renin angiotensin system, 19 and elevated prostaglandins. Platelets also, through a method of adhesion, secretion, and aggregation, alter the basement membrane of cell walls.…”

Treating Retinopathies – Nanotechnology as a Tool in Protecting Antioxidants Agents

“…Oxidative stress is also associated with increased vascular permeability, disruption of blood-retinal barrier, apoptotic loss of retinal capillary cells, microvascular abnormalities, and neovascularization (Kowluru and Koppolu 2002). When such conditions are presented, without an effective medical treatment, cells and tissues of the retina become malnourished and progressively degenerate, which leads to damage in cells responsible for vision, leading to its inevitable loss (Chu and Ali 2008).…”

“…There are many types of retinopathy conditions such as retinitis pigmentosa, glaucoma, cataracts, macular degeneration, retinoblastoma, and diabetic retinopathy (Chu and Ali 2008;You et al 2011). Multiple factors have been proposed to explain retinopathies, including genetic disorders, infections by microbial agents, sorbitol pathway hyperactivity, accumulation of advanced glycation end products (AGEs) (Glenn and Stitt 2009), protein kinase C activation (Wiwanitkit 2007), and oxidative stress (Aruoma et al 2007;Chu and Ali 2008).…”

“…Multiple factors have been proposed to explain retinopathies, including genetic disorders, infections by microbial agents, sorbitol pathway hyperactivity, accumulation of advanced glycation end products (AGEs) (Glenn and Stitt 2009), protein kinase C activation (Wiwanitkit 2007), and oxidative stress (Aruoma et al 2007;Chu and Ali 2008). These disorders often result in changes on reflectivity, bifurcations, tortuosity neovascularization, and even blindness (Chu and Ali 2008;You et al 2011). The ocular globe is the organ most affected by oxidative stress, since its intense exposure to light and oxygen and its high polyunsaturated fatty acid (PUFA) content that is prone to lipid peroxidation (Terrasa et al 2009).…”