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Retinal non-perfusion in diabetic retinopathy
Charles C Wykoff1,2, Hannah J Yu3, Robert L Avery4
1Retina Consultants of Texas, Retina Consultants of America, Houston, TX, USA. charleswykoff@gmail.com.
Eye (London, England)
|January 12, 2022
Summary
Diabetic retinopathy causes vision loss, with retinal non-perfusion (RNP) worsening its severity. Current treatments slow RNP but cannot restore perfusion, highlighting the need for new therapies targeting RNP progression.
Area of Science:
- Ophthalmology
- Vascular Biology
- Diabetic Complications
Background:
- Diabetic retinopathy (DR) is a leading cause of blindness globally.
- Retinal non-perfusion (RNP) is a critical vascular pathology in DR, linked to disease severity.
- Understanding RNP progression is crucial for managing DR.
Purpose of the Study:
- To explore the natural history and progression of RNP in diabetic retinopathy.
- To investigate quantitative image assessment methods for RNP.
- To identify novel therapeutic targets for RNP and retinal reperfusion.
Main Methods:
- Review of current understanding of RNP development and progression in DR.
- Exploration of traditional and novel quantitative image assessment techniques.
- Analysis of current therapeutic strategies and their limitations regarding RNP.
Main Results:
- Increasing RNP correlates with worsening DR severity.
- Current anti-VEGF and steroid therapies may slow RNP accumulation but do not reperfuse RNP areas.
- Significant unmet need exists for therapies that promote RNP reperfusion.
Conclusions:
- Effective treatments for diabetic retinopathy must address RNP progression and aim for retinal reperfusion.
- Novel therapeutic targets, such as the semaphorin family, are under investigation for their potential to treat RNP.
- Further research is needed to develop pharmacotherapies capable of reversing RNP and restoring retinal perfusion.
