Role of Inflammation in Diabetic Retinopathy

Abstract

As the global burden of diabetes is increasing there is a corresponding increase in the complications associated with the same. Diabetic retinopathy is a sight threatening complication of diabetes mellitus which was considered to be a microvasculopathy. Recent evidence however, has brought to light that inflammation may be a key player in the pathogenesis of this condition. Levels of inflammatory mediators like Hypoxia inducible factor, TNF-α, IL-6 and IL-1B amongst others have been noted to be elevated in the diabetic vitreous gel. The concept of the neurovascular unit better explains the changes that take place resulting in the breakdown of the blood retinal barriers and how these inflammatory mediators affect the morphology of the retina at a cellular level. Glial cells form a key instrument of this neurovascular structure and are also the cells from where the inflammatory response is initiated. Understanding of the pathogenesis of diabetic retinopathy will help us in finding targeted therapies which may provide long term benefits and possible cure. Few anti-inflammatory medications have shown promise albeit in a small clinical or experimental laboratory setting. However, future research may lead to better understanding of the disease and a better pharmacological intervention.