5 :: KDA, Korean Diabetes Association ::
string(8) "resource"
Subject    :    [2018 Oct;42(5)] Pathophysiology of Diabetic Retinopathy: The Old and the New
Writer KDA
Date 2019-03-06 09:59:19 Hit 317
Diabetes Metab J. 2018 Oct;42(5):364-376. English.
Published online Oct 22, 2018.  https://doi.org/10.4093/dmj.2018.0182 
Copyright © 2018 Korean Diabetes Association
   
Pathophysiology of Diabetic Retinopathy: The Old and the New
Sentaro Kusuhara,1 Yoko Fukushima,2 Shuntaro Ogura,3,4 Naomi Inoue,3 and Akiyoshi Uemura3
1Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
2Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
3Department of Retinal Vascular Biology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
4Department of Ophthalmology, Wilmer Ophthalmological Institute, Johns Hopkins Hospital, Baltimore, MD, USA.

Corresponding author: Akiyoshi Uemura. Department of Retinal Vascular Biology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan. Email: uemura@med.nagoya-cu.ac.jp 
 
Received September 14, 2018; Accepted October 05, 2018.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

 
Abstract

Vision loss in diabetic retinopathy (DR) is ascribed primarily to retinal vascular abnormalities—including hyperpermeability, hypoperfusion, and neoangiogenesis—that eventually lead to anatomical and functional alterations in retinal neurons and glial cells. Recent advances in retinal imaging systems using optical coherence tomography technologies and pharmacological treatments using anti-vascular endothelial growth factor drugs and corticosteroids have revolutionized the clinical management of DR. However, the cellular and molecular mechanisms underlying the pathophysiology of DR are not fully determined, largely because hyperglycemic animal models only reproduce limited aspects of subclinical and early DR. Conversely, non-diabetic mouse models that represent the hallmark vascular disorders in DR, such as pericyte deficiency and retinal ischemia, have provided clues toward an understanding of the sequential events that are responsible for vision-impairing conditions. In this review, we summarize the clinical manifestations and treatment modalities of DR, discuss current and emerging concepts with regard to the pathophysiology of DR, and introduce perspectives on the development of new drugs, emphasizing the breakdown of the blood-retina barrier and retinal neovascularization.

   
Keywords:
AngiopoietinsBlood-retina barrierDiabetic retinopathyEndothelial cellsMacular edemaPericytesRetinal neovascularizationVascular endothelial growth factors

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