Pathophysiology of Diabetic Retinopathy: The Old and the New.
Pathophysiology of Diabetic Retinopathy: The Old and the New.
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DOI：
10.4093/dmj.2018.0182
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发表时间：
2018-10
影响因子：
5.9
通讯作者：
Uemura A
中科院分区：
文献类型：
--
作者：
Kusuhara S;Fukushima Y;Ogura S;Inoue N;Uemura A
糖尿病视网膜病变（DR）的视力丧失主要归因于视网膜血管异常，包括高通透性、低灌注和新生血管生成，最终导致视网膜神经元和神经胶质细胞的解剖和功能改变。使用光学相干断层扫描技术的视网膜成像系统和使用抗血管内皮生长因子药物和皮质类固醇的药理学治疗的最新进展已经彻底改变了DR的临床管理。然而，DR的病理生理学基础的细胞和分子机制尚未完全确定，主要是因为高血糖动物模型仅再现亚临床和早期DR的有限方面。非糖尿病小鼠模型代表了DR中的标志性血管疾病，例如周细胞缺乏和视网膜缺血，其为理解导致视力损害状况的连续事件提供了线索。在这篇综述中，我们总结了DR的临床表现和治疗方式，讨论了有关DR病理生理学的当前和新兴概念，并介绍了新药开发的观点，强调了血视网膜屏障的破坏和视网膜新生血管的形成。
Vision loss in diabetic retinopathy (DR) is ascribed primarily to retinal vascular abnormalities—including hyperpermeability, hypoperfusion, and neoangiogenesis—that eventually lead to anatomical and functional alterations in retinal neurons and glial cells. Recent advances in retinal imaging systems using optical coherence tomography technologies and pharmacological treatments using anti-vascular endothelial growth factor drugs and corticosteroids have revolutionized the clinical management of DR. However, the cellular and molecular mechanisms underlying the pathophysiology of DR are not fully determined, largely because hyperglycemic animal models only reproduce limited aspects of subclinical and early DR. Conversely, non-diabetic mouse models that represent the hallmark vascular disorders in DR, such as pericyte deficiency and retinal ischemia, have provided clues toward an understanding of the sequential events that are responsible for vision-impairing conditions. In this review, we summarize the clinical manifestations and treatment modalities of DR, discuss current and emerging concepts with regard to the pathophysiology of DR, and introduce perspectives on the development of new drugs, emphasizing the breakdown of the blood-retina barrier and retinal neovascularization.
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影响因子：
13.7
作者：
Bressler SB;Beaulieu WT;Glassman AR;Gross JG;Jampol LM;Melia M;Peters MA;Rauser ME;Diabetic Retinopathy Clinical Research Network
通讯作者：
Diabetic Retinopathy Clinical Research Network
影响因子：
4.1
作者：
Arevalo, J. F.;Maia, M.;Sanchez, J. G.
通讯作者：
Sanchez, J. G.
影响因子：
5.6
作者：
Bolinger MT;Antonetti DA
通讯作者：
Antonetti DA
影响因子：
15.9
作者：
Barber, AJ;Lieth, E;Gardner, TW
通讯作者：
Gardner, TW
影响因子：
8.2
作者：
Friedrichs, Patrick;Schlotterer, Andrea;Hammes, Hans-Peter
通讯作者：
Hammes, Hans-Peter