Neurodegeneration in diabetic retinopathy: Current concepts and therapeutic implications

Abstract

Diabetic retinopathy (DR), the most common complication of diabetes and one of the leading causes of preventable blindness, has been considered to be a microcirculatory disease of the retina. However, there is emerging evidence to suggest that retinal neurodegeneration is an early event in the pathogenesis of DR, which participates in the development of microvascular abnormalities. Therefore, the study of the underlying mechanisms leading to neurodegeneration and the identification of the mediators linking neurodegeneration and microangiopathy will be essential for the development of new therapeutic strategies in the early stages of DR. In this review the mechanisms involved in neurodegeneration, as well as the link between neurodegeneration and microangiopathy have been updated. Finally, the therapeutic implications and new perspectives based on identifying those patients with retinal neurodegeneration are presented.