Neurodegeneration in diabetic retinopathy: Potential for novel therapies

Alistair Barber, Basma Baccouche

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

The complex pathology of diabetic retinopathy (DR) affects both vascular and neural tissue. The characteristics of neurodegeneration are well-described in animal models but have more recently been confirmed in the clinical setting, mostly by using non-invasive imaging approaches such as spectral domain optical coherence tomography (SD-OCT). The most frequent observations report loss of tissue in the nerve fiber layer and inner plexiform layer, confirming earlier findings from animal models. In several cases the reduction in inner retinal layers is reported in patients with little evidence of vascular lesions or macular edema, suggesting that degenerative loss of neural tissue in the inner retina can occur after relatively short durations of diabetes. Animal studies also suggest that neurodegeneration leading to retinal thinning is not limited to cell death and tissue loss but also includes changes in neuronal morphology, reduced synaptic protein expression and alterations in neurotransmission, including changes in expression of neurotransmitter receptors as well as neurotransmitter release, reuptake and metabolism. The concept of neurodegeneration as an early component of DR introduces the possibility to explore alternative therapies to prevent the onset of vision loss, including neuroprotective therapies and drugs targeting individual neurotransmitter systems, as well as more general neuroprotective approaches to preserve the integrity of the neural retina. In this review we consider some of the evidence for progressive retinal neurodegeneration in diabetes, and explore potential neuroprotective therapies.

Original languageEnglish (US)
Pages (from-to)82-92
Number of pages11
JournalVision Research
Volume139
DOIs
StatePublished - Oct 1 2017

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Diabetic Retinopathy
Neurotransmitter Agents
Blood Vessels
Retina
Animal Models
Neurotransmitter Receptor
Macular Edema
Optical Coherence Tomography
Neuroprotective Agents
Therapeutics
Drug Delivery Systems
Complementary Therapies
Nerve Fibers
Synaptic Transmission
Cell Death
Pathology
Proteins

All Science Journal Classification (ASJC) codes

  • Ophthalmology
  • Sensory Systems

Cite this

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Neurodegeneration in diabetic retinopathy : Potential for novel therapies. / Barber, Alistair; Baccouche, Basma.

In: Vision Research, Vol. 139, 01.10.2017, p. 82-92.

Research output: Contribution to journalArticle

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