Retinal Neurodegeneration in Diabetes: an Emerging Concept in Diabetic Retinopathy.
Retinal Neurodegeneration in Diabetes: an Emerging Concept in Diabetic Retinopathy.
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糖尿病中的视网膜神经退行性变：糖尿病视网膜病变中的一个新观念
DOI：
10.1007/s11892-021-01428-x
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发表时间：
2021-12-13
影响因子：
4.2
通讯作者：
Sachdeva MM
中科院分区：
文献类型：
--
作者：
Sachdeva MM
糖尿病视网膜病变（DR）是工作年龄成人致盲的主要原因，其临床定义和分期仍取决于其血管表现。然而，早期视网膜神经变性可能先于血管病变，这表明这种神经元损伤可能有助于疾病的发病机制，并代表一个独立的干预目标。本文将讨论糖尿病视网膜神经变性的证据和影响。越来越多的文献已经确定糖尿病患者甚至在DR发病之前就出现进行性视网膜变薄和视觉功能障碍，尽管视网膜血管成像的进展表明血管重塑和脉络膜变化也发生在这些早期阶段。糖尿病的动物模型和体外研究也表明，糖尿病可能直接影响视网膜神经和神经胶质组织，这为糖尿病视网膜神经变性发生在疾病早期的概念提供了支持，并提示了潜在的相关分子途径。糖尿病视网膜神经变性可能代表糖尿病视网膜疾病的“临床前”表现，并且仍然是研究的活跃领域。随着对DR的自然史和分子机制的了解越来越多，不仅在治疗方案上，而且在DR的临床定义上都可能会有新的发展。
Diabetic retinopathy (DR), the leading cause of blindness in working-aged adults, remains clinically defined and staged by its vascular manifestations. However, early retinal neurodegeneration may precede vascular pathology, suggesting that this neuronal damage may contribute to disease pathogenesis and represent an independent target for intervention. This review will discuss the evidence and implications for diabetic retinal neurodegeneration. A growing body of literature has identified progressive retinal thinning and visual dysfunction in patients with diabetes even prior to the onset of DR, though advances in retinal vascular imaging suggest that vascular remodeling and choroidal changes occur during these early stages as well. Animal models of diabetes and in vitro studies have also suggested that diabetes may directly affect the retinal neural and glial tissue, providing support to the concept that diabetic retinal neurodegeneration occurs early in the disease and suggesting potentially relevant molecular pathways. Diabetic retinal neurodegeneration may represent a “preclinical” manifestation of diabetic retinal disease and remains an active area of investigation. As the natural history and molecular mechanisms become increasingly understood, it may lead to upcoming developments in not only the treatment options but also the clinical definition of DR.
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影响因子：
1.9
作者：
Goudot MM;Sikorav A;Semoun O;Miere A;Jung C;Courbebaisse B;Srour M;Freiha JG;Souied EH
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Souied EH
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通讯作者：
Theodossiadis, Panagiotis
影响因子：
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作者：
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通讯作者：
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