Targeting the retinal microcirculation to treat diabetic sight problems

Diabetic retinopathy is a secondary complication of hyperglycemia caused by diabetes mellitus. The damage to the retina can ultimately cause vision loss as a result of increased capillary permeability and angiogenesis. Recent progress in the understanding of the mediators that drive angiogenesis, as well as the phenotypes of cells that are involved in this process, has provided a multitude of targets for pharmacologic intervention. This review presents the inhibitors of the biochemical processes that are at the root of diabetic retinopathy (i.e., non-enzymatic glycosylation of biomolecules, oxidative stress, activation of aldose reductase and activation of protein kinase C by formation of diacylglycerol) in addition to the inhibitors of the mechanical damage (i.e., increased vascular permeability, capillary occlusion and neovascularization).