Diabetic retinopathy and systemic vascular complications

Cheung, Ning; Wong, Tien Yin

doi:10.1016/j.preteyeres.2007.12.001

Cited by 214 publications

(175 citation statements)

References 191 publications

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“…The lack of association between RDW and retinopathy was unexpected. We had hypothesised that this microvascular complication would also be related to RDW levels, because of the proposed role of inflammation in the pathogenesis of retinopathy [18] and the association between retinopathy and an increased risk of cardiovascular morbidity and mortality [2]. Recent studies have reported that the relationship between diabetic retinopathy and systemic inflammatory markers, in particular CRP, is weak or non-existent [25][26][27].…”

Section: Discussionmentioning

confidence: 99%

“…Cardiovascular disease (CVD) is the primary cause of mortality in patients with diabetes [1]. Microvascular complications are a major cause of morbidity in diabetes populations and have been associated with heightened risk of systemic vascular complications [1,2]. The identification of markers of macrovascular and microvascular disease could provide new information about the pathogenesis and early diagnosis of diabetes complications and facilitate decision-making in terms of prevention and treatment.…”

Section: Introductionmentioning

confidence: 99%

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Association between red blood cell distribution width and macrovascular and microvascular complications in diabetes

et al. 2011

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Aims/hypothesis Red blood cell distribution width (RDW) has been reported to be a risk marker of morbidity and mortality for cardiovascular disease in various study populations. However, no studies have investigated the relationship between RDW and diabetes complications. We therefore evaluated RDW as a marker of macrovascular and microvascular complications in a nationally representative sample of the adult diabetes population in the USA. Methods A cross-sectional study was performed using the nationwide 1988 to 1994 data set from the Third National Health and Nutrition Examination Survey. The association between RDW quartiles and macrovascular and microvascular complications was evaluated in 2,497 non-pregnant adults aged 20 years and older and affected by diabetes. Logistic regression modelling was used to adjust for potential confounding.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Association between red blood cell distribution width and macrovascular and microvascular complications in diabetes

et al. 2011

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“…Diabetic retinopathy is a common microvascular complication of diabetes [28,29]. Retinal neovascularisation, vascular leakage and retinal oedema are common pathogenic features in diabetic retinopathy and major causes of vision loss in patients with diabetes [15].…”

Section: Discussionmentioning

confidence: 99%

Ischaemia-induced retinal neovascularisation and diabetic retinopathy in mice with conditional knockout of hypoxia-inducible factor-1 in retinal Müller cells

et al. 2011

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Aims/hypothesis Retinal Müller cells are known to produce inflammatory and angiogenic cytokines, which play important roles in diabetic retinopathy. Hypoxia-inducible factor (HIF)-1 has been shown to play a crucial role in retinal inflammation and neovascularisation. We sought to determine the role of Müller cell-derived HIF-1 in oxygeninduced retinopathy (OIR) and diabetic retinopathy using conditional Hif-1α (also known as Hif1a) knockout (KO) mice. Methods Conditional Hif-1α KO mice were generated by crossing mice expressing cyclisation recombinase (cre, also known as P1_gp003) in Müller cells with floxed Hif-1α mice and used for OIR and streptozotocin-induced diabetes to induce retinal neovascularisation and inflammation, respectively. Abundance of HIF-1α and pro-angiogenic and pro-inflammatory factors was measured by immunoblotting and immunohistochemistry. Retinal neovascularisation was visualised by angiography and quantified by counting pre-retinal nuclei. Retinal inflammation was evaluated by leucostasis and vascular leakage. Results While the Hif-1α KO mice showed significantly decreased HIF-1α levels in the retina, they exhibited no apparent histological or visual functional abnormalities (2011( ) 54:1554( -1566( DOI 10.1007( /s00125-011-2081 under normal conditions. Compared with wild-type counterparts, Hif-1α KO mice with OIR demonstrated attenuated overproduction of vascular endothelial growth factor (VEGF) and intercellular adhesion molecule (ICAM)-1, reduced vascular leakage and alleviated neovascularisation in the retina. Under diabetes conditions, disruption of Hif-1α in Müller cells attenuated the increases of retinal vascular leakage and adherent leucocytes, as well as the overproduction of VEGF and ICAM-1. Conclusions/interpretation Müller cell-derived HIF-1α is a key mediator of retinal neovascularisation, vascular leakage and inflammation, the major pathological changes in diabetic retinopathy. Müller cell-derived HIF-1α is therefore a promising therapeutic target for diabetic retinopathy.

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“…Recent studies show that structural retinal microvascular changes, such as the presence of retinopathy or variations in retinal vascular caliber, are predictive of a range of systemic and ocular conditions, such as diabetes, stroke, coronary heart disease and heart failure, and diabetic retinopathy. [1][2][3][4][5][6][7] It has been hypothesized that dilation of retinal vessels in response to diffuse luminance flicker may reflect intrinsic endothelial function, 8 mediated possibly by nitric oxide. [9][10][11][12] Thus, such measurements may allow in vivo quantification of retinal endothelial function, which may help in understanding the physiological and pathological alterations of retinal microcirculation in various ocular and systemic diseases.…”

Section: Introductionmentioning

confidence: 99%