scholarly journals Neurovascular cross talk in diabetic retinopathy: Pathophysiological roles and therapeutic implications

2016 ◽  
Vol 311 (3) ◽  
pp. H738-H749 ◽  
Author(s):  
Elizabeth P. Moran ◽  
Zhongxiao Wang ◽  
Jing Chen ◽  
Przemyslaw Sapieha ◽  
Lois E. H. Smith ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Cross Talk ◽  
Metabolic Stress ◽  
Neurovascular Coupling ◽  
Developed Countries ◽  
Therapeutic Implications ◽  
Vascular Abnormalities ◽  
Guidance Cues ◽  
Chronic Hyperglycemia ◽  
Retinal Microvasculature

Diabetic retinopathy (DR) is the leading cause of blindness in the working-age population in developed countries, and its prevalence will increase as the global incidence of diabetes grows exponentially. DR begins with an early nonproliferative stage in which retinal blood vessels and neurons degenerate as a consequence of chronic hyperglycemia, resulting in vasoregression and persistent retinal ischemia, metabolic disequilibrium, and inflammation. This is conducive to overcompensatory pathological neovascularization associated with advanced proliferative DR. Although DR is considered a microvascular complication, the retinal microvasculature is intimately associated with and governed by neurons and glia; neurodegeneration, neuroinflammation, and dysregulation of neurovascular cross talk are responsible in part for vascular abnormalities in both early nonproliferative DR and advanced proliferative DR. Neuronal activity directly regulates microvascular dilation and blood flow in the process of neurovascular coupling. Retinal neurons also secrete guidance cues in response to injury, ischemia, or metabolic stress that may either promote or suppress vascular outgrowth, either alleviating or exacerbating DR, contingent on the stage of disease and retinal microenvironment. Neurodegeneration, impaired neurovascular coupling, and dysregulation of neuronal guidance cues are key events in the pathogenesis of DR, and correcting these events may prevent or delay development of advanced DR. The review discusses the mechanisms of neurovascular cross talk and its dysregulation in DR, and their potential therapeutic implications.

Diabetic Retinopathy—Update on Prevention Techniques, Present Therapies, and New Leads

2014 ◽  
Vol 10 (01) ◽  
pp. 25
Author(s):  
Lauren M Marozas ◽  
Patrice E Fort ◽  
◽  
Keyword(s):  
Diabetic Retinopathy ◽  
Vision Loss ◽  
Developed Countries ◽  
Detection Methods ◽  
Retinal Microvasculature ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Combined Control ◽  
Working Age ◽  
Proactive Measures

Diabetic retinopathy is the major ocular complication associated with diabetes, and represents the leading cause of legal blindness in the working-age population of developed countries. Although classically diagnosed based on abnormalities of the retinal microvasculature, diabetic retinopathy is now widely recognized as a neurovascular disease. While all patients with diabetes are at increased risk for eye disease including diabetic retinopathy, proactive measures, and timely intervention can prevent or delay subsequent vision loss. Systemic management of diabetes by combined control of glycemia, blood pressure, and serum lipid levels remains the most important method of preventing diabetic retinopathy onset and progression. Once detected, surgical and medical interventions including photocoagulation, vitrectomy, and intravitral drug injection can help preserve vision. However, the need for improved detection methods and therapies that will allow earlier diagnosis and treatment remains apparent. This review summarizes current techniques for the prevention and intervention for diabetic retinopathy, and examines ongoing developments in the search for new endpoints and therapies as they apply to preventing vision loss associated with diabetes.

scholarly journals Decorin Concentrations in Aqueous Humor of Patients with Diabetic Retinopathy

Life ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. 1421
Author(s):  
Shermaine W. Y. Low ◽  
Tanuja Vaidya ◽  
Santosh G. K. Gadde ◽  
Thirumalesh B. Mochi ◽  
Devesh Kumar ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Aqueous Humor ◽  
Treatment Strategies ◽  
Enzyme Linked Immunosorbent Assay ◽  
Great Success ◽  
Variable Response ◽  
Compensatory Response ◽  
Cross Sectional ◽  
Chronic Hyperglycemia ◽  
Retinal Microvasculature

Diabetic retinopathy (DR) is a microvascular complication of diabetes in the retina. Chronic hyperglycemia damages retinal microvasculature embedded into the extracellular matrix (ECM), causing fluid leakage and ischemic retinal neovascularization. Current treatment strategies include intravitreal anti-vascular endothelial growth factor (VEGF) or steroidal injections, laser photocoagulation, or vitrectomy in severe cases. However, treatment may require multiple modalities or repeat treatments due to variable response. Though DR management has achieved great success, improved, long-lasting, and predictable treatments are needed, including new biomarkers and therapeutic approaches. Small-leucine rich proteoglycans, such as decorin, constitute an integral component of retinal endothelial ECM. Therefore, any damage to microvasculature can trigger its antifibrotic and antiangiogenic response against retinal vascular pathologies, including DR. We conducted a cross-sectional study to examine the association between aqueous humor (AH) decorin levels, if any, and severity of DR. A total of 82 subjects (26 control, 56 DR) were recruited. AH was collected and decorin concentrations were measured using an enzyme-linked immunosorbent assay (ELISA). Decorin was significantly increased in the AH of DR subjects compared to controls (p = 0.0034). AH decorin levels were increased in severe DR groups in ETDRS and Gloucestershire classifications. Decorin concentrations also displayed a significant association with visual acuity (LogMAR) measurements. In conclusion, aqueous humor decorin concentrations were found elevated in DR subjects, possibly due to a compensatory response to the retinal microvascular changes during hyperglycemia.

scholarly journals Diabetic Retinopathy—Update on Prevention Techniques, Present Therapies, and New Leads

2014 ◽  
Vol 07 (01) ◽  
pp. 54 ◽  
Author(s):  
Lauren M Marozas ◽  
Patrice E Fort ◽  
◽  
Keyword(s):  
Diabetic Retinopathy ◽  
Vision Loss ◽  
Developed Countries ◽  
Detection Methods ◽  
Retinal Microvasculature ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Combined Control ◽  
Working Age ◽  
Proactive Measures

Diabetic retinopathy is the major ocular complication associated with diabetes, and represents the leading cause of legal blindness in the working-age population of developed countries. Although classically diagnosed based on abnormalities of the retinal microvasculature, diabetic retinopathy is now widely recognized as a neurovascular disease. While all patients with diabetes are at increased risk for eye disease including diabetic retinopathy, proactive measures, and timely intervention can prevent or delay subsequent vision loss. Systemic management of diabetes by combined control of glycemia, blood pressure, and serum lipid levels remains the most important method of preventing diabetic retinopathy onset and progression. Once detected, surgical and medical interventions including photocoagulation, vitrectomy, and intravitral drug injection can help preserve vision. However, the need for improved detection methods and therapies that will allow earlier diagnosis and treatment remains apparent. This review summarizes current techniques for the prevention and intervention for diabetic retinopathy, and examines ongoing developments in the search for new endpoints and therapies as they apply to preventing vision loss associated with diabetes.

scholarly journals 2D alpha-shapes to quantify retinal microvasculature morphology and their application to proliferative diabetic retinopathy characterisation in fundus photographs

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Emma Pead ◽  
Ylenia Giarratano ◽  
Andrew J. Tatham ◽  
Miguel O. Bernabeu ◽  
Baljean Dhillon ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Proliferative Diabetic Retinopathy ◽  
Imaging Biomarkers ◽  
Cross Sectional ◽  
Vascular Abnormalities ◽  
Small Vessels ◽  
Alpha Shapes ◽  
Retinal Microvasculature ◽  
Fundus Photographs ◽  
Sectional Analysis

AbstractThe use of 2D alpha-shapes (α-shapes) to quantify morphological features of the retinal microvasculature could lead to imaging biomarkers for proliferative diabetic retinopathy (PDR). We tested our approach using the MESSIDOR dataset that consists of colour fundus photographs from 547 healthy individuals, 149 with mild diabetic retinopathy (DR), 239 with moderate DR, 199 pre-PDR and 53 PDR. The skeleton (centrelines) of the automatically segmented retinal vasculature was represented as an α-shape and the proposed parameters, complexity ($${Op\alpha }_{min}$$ O p α min ), spread (OpA), global shape (VS) and presence of abnormal angiogenesis (Gradα) were computed. In cross-sectional analysis, individuals with PDR had a lower $${Op\alpha }_{min}$$ O p α min , OpA and Gradα indicating a vasculature that is more complex, less spread (i.e. dense) and the presence of numerous small vessels. The results show that α-shape parameters characterise vascular abnormalities predictive of PDR (AUC 0.73; 95% CI [0.73 0.74]) and have therefore potential to reveal changes in retinal microvascular morphology.

scholarly journals Doctor's Role in Early Detection of Diabetic Retinopathy and Prevention of Blindness from its Complications

2005 ◽  
Vol 44 (157) ◽  
Author(s):  
Sudesh Subedi ◽  
K U Subedi ◽  
B P Badhu
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Retinopathy ◽  
Early Detection ◽  
Type I Diabetes ◽  
Developed Countries ◽  
Type I ◽  
Rapid Urbanization ◽  
Chronic Hyperglycemia ◽  
Working Age ◽  
Diabetic Population

Diabetic retinopathy (DR) is a microangiopathy, which is caused by chronic hyperglycemia, affecting theretinal arterioles, capillaries and venules, complications of which lead to incurable blindness.Approximately 10% of the diabetic population has type I diabetes mellitus (DM) which is diagnosed beforethe age of 30 years1 and rest is type II which is diagnosed after the age of 30 years. In UK 2% generalpopulation is affected by DM. In developed countries, diabetic retinopathy is an important and leadingcause of blindness in working age group where as in developing western countries this figure occupy 12% ofthe blindness.In developing countries like Nepal, cataract still remains a main cause of blindness and diabetes is notconsidered as a major problem. However due to a rapid urbanization and modernization of population,diabetes mellitus is becoming an endemic disease and bringing a new challenge in blindness reduction program.Key Words: Early detection of DR, Classification of DR, Complications, Prevention of blindness.

scholarly journals Diabetic Retinopathy Prediction by Ensemble Learning Based on Biochemical and Physical Data

Sensors ◽  
2021 ◽  
Vol 21 (11) ◽  
pp. 3663
Author(s):  
Zun Shen ◽  
Qingfeng Wu ◽  
Zhi Wang ◽  
Guoyi Chen ◽  
Bin Lin
Keyword(s):  
Diabetic Retinopathy ◽  
Prediction Model ◽  
Ensemble Learning ◽  
Positive Impact ◽  
Reduction Rate ◽  
Developed Countries ◽  
Small Sample ◽  
Feature Reduction ◽  
Physical Data ◽  
Diabetes Retinopathy

(1) Background: Diabetic retinopathy, one of the most serious complications of diabetes, is the primary cause of blindness in developed countries. Therefore, the prediction of diabetic retinopathy has a positive impact on its early detection and treatment. The prediction of diabetic retinopathy based on high-dimensional and small-sample-structured datasets (such as biochemical data and physical data) was the problem to be solved in this study. (2) Methods: This study proposed the XGB-Stacking model with the foundation of XGBoost and stacking. First, a wrapped feature selection algorithm, XGBIBS (Improved Backward Search Based on XGBoost), was used to reduce data feature redundancy and improve the effect of a single ensemble learning classifier. Second, in view of the slight limitation of a single classifier, a stacking model fusion method, Sel-Stacking (Select-Stacking), which keeps Label-Proba as the input matrix of meta-classifier and determines the optimal combination of learners by a global search, was used in the XGB-Stacking model. (3) Results: XGBIBS greatly improved the prediction accuracy and the feature reduction rate of a single classifier. Compared to a single classifier, the accuracy of the Sel-Stacking model was improved to varying degrees. Experiments proved that the prediction model of XGB-Stacking based on the XGBIBS algorithm and the Sel-Stacking method made effective predictions on diabetes retinopathy. (4) Conclusion: The XGB-Stacking prediction model of diabetic retinopathy based on biochemical and physical data had outstanding performance. This is highly significant to improve the screening efficiency of diabetes retinopathy and reduce the cost of diagnosis.

scholarly journals Electrical activity in rat retina in a streptozotocin-induced diabetes model

2018 ◽  
Vol 21 (5) ◽  
pp. 356-363
Author(s):  
Ekaterina M. Klochihina ◽  
Aleksey K. Erdyakov ◽  
Maria P. Morozova ◽  
Svetlana A. Gavrilova ◽  
Elena S. Akhapkina ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Wave Amplitude ◽  
Developed Countries ◽  
Laboratory Animals ◽  
Control Group ◽  
Oscillatory Potential ◽  
Ischaemic Injury ◽  
Rhythmic Stimulation ◽  
Potential Test ◽  
Wave Latency

Objectives: Diabetic retinopathy remains the major cause of blindness among the working-age population of developed countries. Considering this, experimental models of diabetes involving laboratory animals are important for assessing clinically significant methods to determine early pathologic alterations of the retina. The early detection of diabetic retinopathy in combination with a search for new pathogenetic targets will enable focusing on new strategies to limit the development of critical changes in the retina and to prolong retinal functioning during the development of diabetes mellitus. Aim: This study aimed to define parameters of electroretinography test that identifies changes due to retinal impairment in diabetes. Methods: Experimental diabetes was induced in Wistar rats by intraperitoneally injecting streptozocin (65 mg/kg; group DM). The control group (CB) received intraperitoneal injections of the vehicle, i.e. citric buffer. On each consecutive day of the experiment, all rats received insulin detemir (2 u/kg). Ophthalmoscopy and electroretinography were conducted before initiating the experiment and after 50, 58 and 66 days of injectin sptreptozocin. Results: Amid 2u\kg insulin injection the glucose level in venous blood in DM group amounted to 30-40 mM. The ophthalmoscopy showed that the optic nerve disk paled by the 50th day, with its line erasing. During electroretinography, wave amplitude in oscillatory potential test tended to decrease. -wave latency of photopic system increased with -wave latency of photopic system and - and -waves latency of scotopic system not altering. In addition, the amplitude of rhythmic stimulation of 8 and 12 Hz decreased. Conclusion: The most apparent parameters of electroretinography for modelling streptozocin-induced diabetes are wave amplitude during the oscillatory potential test, photopic B-wave latency and the amplitude of rhythmic stimulation. These results suggest that in diabetes, ischaemic injury is an important cause of early dysfunction of inner retinal layers.

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