Moein Ebrahimi, Sobha Sivaprasad, Paul Thompson, George Perry
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引用次数: 0
Abstract
Diabetic retinopathy (DR) is a challenging public health problem mainly because of its growing prevalence and risk of blindness. In general, our current knowledge and practice have failed to prevent the onset or progression of DR to sight-threatening complications. While there are treatment options for sight-threatening complications of DR, it is crucial to pay more attention to the early stages of DR to decrease its prevalence. Growing evidence suggests many pathologic changes occur before clinical presentations of DR in euglycemic hyperinsulinemia, prediabetes, and diabetes. These pathological changes occur in retinal neurons, glia, and microvasculature. A new focus on these preclinical pathologies - especially on hyperinsulinemia - may provide further insight into disease mechanisms, endpoints for clinical trials, and druggable targets in early disease. Here, we review the current evidence on the pathophysiological changes reported in preclinical DR and appraise preventive and treatment options for DR.
糖尿病视网膜病变(DR)是一个具有挑战性的公共卫生问题,这主要是因为它的发病率和致盲风险越来越高。总体而言,我们现有的知识和实践无法预防糖尿病视网膜病变的发生或发展为危及视力的并发症。虽然有治疗危及视力的 DR 并发症的方法,但关键是要更加关注 DR 的早期阶段,以降低其发病率。越来越多的证据表明,在优生高胰岛素血症、糖尿病前期和糖尿病患者出现 DR 临床表现之前,许多病理变化已经发生。这些病理变化发生在视网膜神经元、胶质细胞和微血管中。对这些临床前病理的新关注--尤其是对高胰岛素血症的关注--可为疾病机制、临床试验终点和早期疾病的药物靶点提供进一步的见解。在此,我们回顾了临床前 DR 病理生理变化的现有证据,并评估了 DR 的预防和治疗方案。
期刊介绍:
''Ophthalmic Research'' features original papers and reviews reporting on translational and clinical studies. Authors from throughout the world cover research topics on every field in connection with physical, physiologic, pharmacological, biochemical and molecular biological aspects of ophthalmology. This journal also aims to provide a record of international clinical research for both researchers and clinicians in ophthalmology. Finally, the transfer of information from fundamental research to clinical research and clinical practice is particularly welcome.