Emerging Insights and Interventions for Diabetic Retinopathy
Purpose of Review
To introduce recent advances in the understanding of diabetic retinopathy and to summarize current and emerging strategies to treat this common and complex cause of vision loss.
Advances in retinal imaging and functional analysis indicate that retinal vascular and neural pathologies exist long before the development of clinically visible retinopathy. Such diagnostics could facilitate risk stratification and selective early intervention in high-risk patients. Antagonists of the vascular endothelial growth factor pathway effectively reduce vision loss in diabetes and promote regression of disease severity. Promising new strategies to treat diabetic retinopathy involve novel systemic diabetes therapy and ocular therapies that antagonize angiogenic growth factor signaling, improve blood-retina barrier function and neurovascular coupling, modulate neuroretinal metabolism, or provide neuroprotection.
Long considered a pure microvasculopathy, diabetic retinopathy in fact affects the neural and vascular retina as well as neurovascular communication. Emerging therapies include those that target neuroretinal dysfunction in addition to those modulating vascular biology.
KeywordsDiabetic retinopathy Diabetic macular edema Neuroretinopathy Neurovascular coupling Vascular endothelial growth factor
Eric Nudleman reports grants from the National Eye Institute (5K08EY028999-02). Rithwick Rajagopal reports grants from the National Eye Institute (K08EY025269) and grants from the Research to Prevent Blindness (Career Development Award).
Compliance with Ethical Standards
Conflict of Interest
Avinash Honasoge, Eric Nudleman, Morton Smith, and Rithwick Rajagopal declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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