What else can we do to prevent diabetic retinopathy?

Area of Science:

• Ophthalmology
• Endocrinology
• Metabolic Diseases

Background:

• Diabetic retinopathy (DR) onset and progression are linked to uncontrolled blood glucose, hypertension, and dyslipidemia.
• Less recognized modifiable factors include obesity, adipose tissue distribution, diet, vitamin intake, exercise, smoking, and sunlight exposure.
• Neurodegeneration is an early event in DR development, suggesting neuroprotection as a therapeutic avenue.

Purpose of the Study:

• To review the prevention of diabetic retinopathy by modulating modifiable risk factors.
• To discuss the impact of glucose-lowering drugs on diabetic retinopathy.
• To explore neuroprotection and targeting the neurovascular unit (NVU) for preventing advanced DR.

Main Methods:

• Review of existing literature on modifiable risk factors for diabetic retinopathy.
• Analysis of the role of lifestyle and metabolic factors in DR development.
• Discussion of emerging therapeutic strategies, including neuroprotection and NVU targeting.

Main Results:

• Classical risk factors like hyperglycemia, hypertension, and dyslipidemia are key.
• Obesity, diet, exercise, and smoking also significantly influence DR.
• Emerging evidence highlights neurodegeneration as an early DR event.

Conclusions:

• Modulating modifiable risk factors is crucial for diabetic retinopathy prevention.
• Neuroprotection targeting the neurovascular unit presents a promising strategy for advanced DR.
• Better phenotyping of early DR stages is needed to implement effective interventions.