Diabetic retinopathy is a neurodegenerative disorder.
Diabetic retinopathy is a neurodegenerative disorder.
复制标题
DOI：
10.1016/j.visres.2017.03.003
复制
发表时间：
2017-10
期刊：
影响因子：
1.8
通讯作者：
Abràmoff MD
中科院分区：
文献类型：
--
作者：
Lynch SK;Abràmoff MD
自1875年以来，关于糖尿病眼部并发症本质上主要是血管病变还是神经病变的争论一直存在。在这里，我们讨论了糖尿病视网膜病变（DR）被认为是一种原发性血管病变的历史背景，与最近的数据表明糖尿病视网膜神经变性（DRN）作为糖尿病眼部损害的主要表现的重要性。不出所料，DRN与其他与神经病变相关的糖尿病并发症相似。一般而言，微血管DR和DRN之间存在三种可能的关系：i）微血管病变导致神经变性; ii）神经变性导致微血管病变或iii）它们相互独立。作者小组最近的实验数据显示，DRN甚至先于DR微血管病变的最早表现。结合早期的研究表明，局灶性内隐时间延迟预测了同一部位DR微血管病变的未来发展，关系i）和iii）不太可能。因此，ii）是最可能的关系：DRN是DR的原因之一，需要更多的研究来证实这一假设，并阐明糖尿病诱导的神经退行性变的机制。我们通过提出实验方法来检验DRN导致DR的假设来结束这篇综述。如果得到证实，这种新的范式可能会导致早期检测糖尿病性眼部损伤和早期治疗早期DR，从而防止糖尿病患者的视力丧失。
Since 1875, controversy has ensued over whether ocular diabetic complications are primarily vasculopathic or neuropathic in nature. Here, we discuss the historical context by which diabetic retinopathy (DR) came to be considered a primary vasculopathy, in contrast to more recent data suggesting the importance of diabetic retinal neurodegeneration (DRN) as the primary manifestation of ocular diabetic damage. Unsurprisingly, DRN parallels other diabetic complications related to neuropathy. In general, there are three possible relationships between microvascular DR and DRN: i) microvasculopathy causes neurodegeneration; ii) neurodegeneration causes microvasculopathy or iii) they are mutually independent. The authors' group has recently produced experimental data showing that DRN precedes even the earliest manifestations of DR microvasculopathy. In combination with earlier studies showing that focal implicit time delays predicted future development of DR microvasculopathy in the same location, relationships i) and iii) are unlikely. As such, ii) is the most likely relationship: DRN is a cause of DR. Granted, additional studies are needed to confirm this hypothesis and elucidate the mechanism of diabetes-induced neurodegeneration. We conclude this review by proposing experimental approaches to test the hypothesis that DRN causes DR. If confirmed, this new paradigm may lead to earlier detection of ocular diabetic damage and earlier treatment of early DR, thereby preventing visual loss in people with diabetes.
登录
查看更多内容
影响因子：
3.7
作者：
Abràmoff MD;Wu X;Lee K;Tang L
通讯作者：
Tang L
影响因子：
15.9
作者：
Barber, AJ;Lieth, E;Gardner, TW
通讯作者：
Gardner, TW
影响因子：
4.4
作者：
Bogunovic, Hrvoje;Kwon, Young H.;Abramoff, Michael D.
通讯作者：
Abramoff, Michael D.
影响因子：
3.5
作者：
Bitirgen, G.;Ozkagnici, A.;Kerimoglu, H.
通讯作者：
Kerimoglu, H.
影响因子：
3.8
作者：
Beltramo, Elena;Lopatina, Tatiana;Porta, Massimo
通讯作者：
Porta, Massimo