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Eye (2022)
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Diabetic retinopathy (DR) may lead to vision-threatening complications in people living with diabetes mellitus. Decades of research have contributed to our understanding of the pathogenesis of diabetic retinopathy from non-proliferative to proliferative (PDR) stages, the occurrence of diabetic macular oedema (DMO) and response to various treatment options. Multimodal imaging has paved the way to predict the impact of peripheral lesions and optical coherence tomography-angiography is starting to provide new knowledge on diabetic macular ischaemia. Moreover, the availability of intravitreal anti-vascular endothelial growth factors has changed the treatment paradigm of DMO and PDR. Areas of research have explored mechanisms of breakdown of the blood-retinal barrier, damage to pericytes, the extent of capillary non-perfusion, leakage and progression to neovascularisation. However, knowledge gaps remain. From this perspective, we highlight the challenges and future directions of research in this field.
糖尿病视网膜病变 (DR) 可导致糖尿病患者出现威胁视力的并发症。数十年的研究有助于我们了解糖尿病视网膜病变从非增殖期 (NPDR) 到增殖期 (PDR) 的发病机制, 糖尿病黄斑水肿 (DMO) 的发生和对各种治疗方案的反应。多模态成像为视网膜周边病变提供了有力武器, 光学相干断层成像-血管造影 (OCTA) 已经广泛应用于糖尿病黄斑缺血的诊断。此外, 玻璃体内抗血管内皮生长因子 (抗-VEGF) 药物的应用改变了DMO和PDR的治疗模式。在研究领域对血-视网膜屏障破坏, 周细胞损伤, 毛细血管无灌注, 渗漏和新生血管的发生机制进行了阐述。然而, 我们仍然面临着许多未知。本文, 我们强调了这个领域的挑战和未来的发展方向。
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This manuscript was prepared for the European Vision Institute.
SS and SSen are funded by UKRI Global Challenge Research Fund [MR/P027881/1]. SS is supported by the NIHR Biomedical Research Centre at Moorfields Eye Hospital National Health Service (NHS) Foundation Trust and the University College London Institute of Ophthalmology. José Cunha-Vaz is funded by AIBILI and Fundo de Inovação Tecnologia e Economia Circular (FITEC)—Programa Interface (FITEC/CIT/2018/2).
NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust, London, UK
Sobha Sivaprasad
Department of Retina and Vitreous, Aravind Eye Hospital and Aravind Medical Research Foundation, Madurai, India
Sagnik Sen
Moorfields Eye Hospital, NHS Foundation Trust, London, United Kingdom
Sagnik Sen
AIBILI – Association for Innovation and Biomedical Research on Light and Image, Coimbra, Portugal
José Cunha-Vaz
University of Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, Coimbra, Portugal
José Cunha-Vaz
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SS, SSen and JCV – concept, writing, proofing
Correspondence to Sobha Sivaprasad.
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Sivaprasad, S., Sen, S. & Cunha-Vaz, J. Perspectives of diabetic retinopathy—challenges and opportunities. Eye (2022). https://doi.org/10.1038/s41433-022-02335-5
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Received: 08 March 2022
Revised: 16 September 2022
Accepted: 25 November 2022
Published: 09 December 2022
DOI: https://doi.org/10.1038/s41433-022-02335-5
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