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Pathophysiology of diabetic retinopathy
Joanna M Tarr1, Kirti Kaul1, Mohit Chopra1
1Institute of Biomedical and Clinical Science, Peninsula College of Medicine and Dentistry, University of Exeter, St Luke's Campus, Magdalen Road, Exeter EX1 2LU, UK.
ISRN Ophthalmology
|February 25, 2014
Summary
Diabetic retinopathy (DR) is a leading cause of blindness. This review explores the biochemical pathways, including hyperglycemia, linking diabetes to retinal microvascular damage and potential new therapies.
Area of Science:
- Ophthalmology
- Endocrinology
- Biochemistry
Background:
- Diabetes is a global epidemic, projected to affect 380 million by 2025.
- Diabetic retinopathy (DR) is the primary cause of blindness in adults aged 20-74.
- Chronic hyperglycemia is linked to DR, but mechanisms of retinal microvascular damage are unclear.
Purpose of the Study:
- To review proposed biochemical pathways contributing to diabetic retinopathy.
- To discuss the role of hyperglycemia in retinal microvascular damage.
- To introduce potential new pharmacological therapies for DR.
Main Methods:
- Literature review of studies on diabetic retinopathy pathogenesis.
- Analysis of biochemical pathways implicated in DR.
- Discussion of emerging pharmacological targets.
Main Results:
- Multiple pathways identified: polyol pathway, protein kinase C (PKC) activation, growth factor (VEGF, IGF-1) expression.
- Other contributors include hemodynamic changes, advanced glycation endproducts (AGEs), oxidative stress, RAAS activation, inflammation, and capillary occlusion.
- These pathways offer targets for novel DR therapies.
Conclusions:
- Understanding the interconnecting biochemical pathways is crucial for preventing DR.
- Targeting these mechanisms offers promising avenues for new pharmacological treatments.
- Further research is needed to elucidate the precise role of each pathway in DR progression.
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