scholarly journals Diabetic Retinopathy and Ocular Melanoma: How Far We Are?

2020 ◽  
Vol 10 (8) ◽  
pp. 2777
Author(s):  
Eliana B. Souto ◽  
Joana R. Campos ◽  
Raquel Da Ana ◽  
Joana F. Fangueiro ◽  
Carlos Martins-Gomes ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Vision Loss ◽  
Ocular Melanoma ◽  
Retinal Neurons ◽  
Correct Treatment ◽  
Resistance To Therapy ◽  
New Therapies ◽  
Patients With Diabetes ◽  
Inflammatory Molecules ◽  
Over Time

Diabetic retinopathy causes vascular damage to retinal neurons, presenting characteristics of chronic inflammation. The development of new therapies capable of combating vision loss involves knowledge of inflammatory retinal changes. Studies in animal models and patients with diabetes have shown a high expression of the inflammatory molecules that are involved in the progression of diabetic retinopathy. Uveal melanoma is an eye tumour that remains highly deadly, because despite the correct treatment, it still causes metastasis in about 50% of patients. This type of tumour has the ability to produce and store melanin, which may result in resistance to therapy. Over time there has been development of new therapies for this disease, such as radiotherapy and surgical resection. In this review, we discuss diabetic retinopathy and ocular melanoma, their relationship with angiogenesis and the current anti-angiogenic therapies for their treatment.

Diabetic Retinopathy—Update on Prevention Techniques, Present Therapies, and New Leads

2014 ◽  
Vol 10 (01) ◽  
pp. 25
Author(s):  
Lauren M Marozas ◽  
Patrice E Fort ◽  
◽  
Keyword(s):  
Diabetic Retinopathy ◽  
Vision Loss ◽  
Developed Countries ◽  
Detection Methods ◽  
Retinal Microvasculature ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Combined Control ◽  
Working Age ◽  
Proactive Measures

Diabetic retinopathy is the major ocular complication associated with diabetes, and represents the leading cause of legal blindness in the working-age population of developed countries. Although classically diagnosed based on abnormalities of the retinal microvasculature, diabetic retinopathy is now widely recognized as a neurovascular disease. While all patients with diabetes are at increased risk for eye disease including diabetic retinopathy, proactive measures, and timely intervention can prevent or delay subsequent vision loss. Systemic management of diabetes by combined control of glycemia, blood pressure, and serum lipid levels remains the most important method of preventing diabetic retinopathy onset and progression. Once detected, surgical and medical interventions including photocoagulation, vitrectomy, and intravitral drug injection can help preserve vision. However, the need for improved detection methods and therapies that will allow earlier diagnosis and treatment remains apparent. This review summarizes current techniques for the prevention and intervention for diabetic retinopathy, and examines ongoing developments in the search for new endpoints and therapies as they apply to preventing vision loss associated with diabetes.

scholarly journals Reduction of Glut1 in retinal neurons but not the RPE alleviates polyol accumulation and normalizes early characteristics of diabetic retinopathy

2020 ◽  
Author(s):  
Nicholas C. Holoman ◽  
Jacob J. Aiello ◽  
Timothy D. Trobenter ◽  
Matthew J. Tarchick ◽  
Michael R. Kozlowski ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Diabetic Retinopathy ◽  
Aldose Reductase ◽  
Glucose Transporter ◽  
Vision Loss ◽  
Significant Proportion ◽  
Diabetic Patients ◽  
Retinal Neurons ◽  
Anti Vegf ◽  
Facilitative Glucose Transporter

AbstractHyperglycemia is a key determinant for development of diabetic retinopathy (DR). Inadequate glycemic control exacerbates retinopathy, while normalization of glucose levels delays its progression. In hyperglycemia, hexokinase is saturated and excess glucose is metabolized to sorbitol by aldose reductase via the polyol pathway. Therapies to reduce retinal polyol accumulation for the prevention of DR have been elusive due to low sorbitol dehydrogenase levels in the retina and inadequate inhibition of aldose reductase. Using systemic and conditional genetic inactivation, we targeted the primary facilitative glucose transporter in the retina, Glut1, as a preventative therapeutic in diabetic male and female mice. Unlike wildtype diabetics, diabetic Glut1+/− mice did not display elevated Glut1 levels in the retina. Furthermore, diabetic Glut1+/− mice exhibited ameliorated ERG defects, inflammation and oxidative stress, which was correlated with a significant reduction in retinal sorbitol accumulation. RPE-specific reduction of Glut1 did not prevent an increase in retinal sorbitol content or early hallmarks of DR. However, like diabetic Glut1+/− mice, reduction of Glut1 specifically in retinal neurons mitigated polyol accumulation and completely prevented retinal dysfunction and the elevation of markers for oxidative stress and inflammation associated with diabetes. These results suggest that modulation of retinal polyol accumulation via Glut1 in photoreceptors can circumvent the difficulties in regulating systemic glucose metabolism and be exploited to prevent DR.SignificanceDiabetic retinopathy (DR) affects one third of diabetic patients and is the primary cause of vision loss in adults aged 20-74. While anti-VEGF and photocoagulation treatments for the late-stage vision threatening complications can prevent vision loss, a significant proportion of patients do not respond to anti-VEGF therapies and mechanisms to stop progression of early-stage symptoms remain elusive. Glut1 is the primary facilitative glucose transporter for the retina. We determined that a moderate reduction in Glut1 levels, specifically in retinal neurons, but not the RPE, was sufficient to prevent retinal polyol accumulation and the earliest functional defects to be identified in the diabetic retina. Our study defines modulation of Glut1 in retinal neurons as a targetable molecule for prevention of DR.

scholarly journals Detection of Diabetic Retinopathy Based on Convolutional Neural Networks: A Review

2021 ◽  
pp. 1-15
Author(s):  
Halbast Rashid Ismael ◽  
Adnan Mohsin Abdulazeez ◽  
Dathar Abas Hasan
Keyword(s):  
Neural Networks ◽  
Diabetic Retinopathy ◽  
Convolutional Neural Networks ◽  
Vision Loss ◽  
Human Vision ◽  
Early Screening ◽  
Slowing Down ◽  
Manual Diagnostics ◽  
Patients With Diabetes ◽  
Paper Review

A major cause of human vision loss worldwide is Diabetic retinopathy (DR). The disease requires early screening for slowing down the progress. However, in low-resource settings where few ophthalmologists are available to care for all patients with diabetes, the clinical diagnosis of DR will be a considerable challenge. This paper, review the most recent studies on the detection of DR by using one of the efficient algorithms of deep learning, which is Convolutional Neural Networks (CNN), which highly used to detect DR features from retinal images. CNNs approach to DR detection saves time and expense, and is more efficient and accurate than manual diagnostics. Therefore, CNN is essential and beneficial for DR detection.

scholarly journals Photoreceptor responses to light in the pathogenesis of diabetic retinopathy

2020 ◽  
Vol 37 ◽  
Author(s):  
Shahriyar P. Majidi ◽  
Rithwick Rajagopal
Keyword(s):  
Diabetic Retinopathy ◽  
Clinical Evidence ◽  
Vision Loss ◽  
Light Modulation ◽  
Retinal Neurons ◽  
Microvascular Networks ◽  
Common Cause ◽  
The World ◽  
Growing Body ◽  
Retinal Vascular Disease

Abstract Vision loss, among the most feared complications of diabetes, is primarily caused by diabetic retinopathy, a disease that manifests in well-recognized, characteristic microvascular lesions. The reasons for retinal susceptibility to damage in diabetes are unclear, especially considering that microvascular networks are found in all tissues. However, the unique metabolic demands of retinal neurons could account for their vulnerability in diabetes. Photoreceptors are the first neurons in the visual circuit and are also the most energy-demanding cells of the retina. Here, we review experimental and clinical evidence linking photoreceptors to the development of diabetic retinopathy. We then describe the influence of retinal illumination on photoreceptor metabolism, effects of light modulation on the severity of diabetic retinopathy, and recent clinical trials testing the treatment of diabetic retinopathy with interventions that impact photoreceptor metabolism. Finally, we introduce several possible mechanisms that could link photoreceptor responses to light and the development of retinal vascular disease in diabetes. Collectively, these concepts form the basis for a growing body of investigative efforts aimed at developing novel pharmacologic and nonpharmacologic tools that target photoreceptor physiology to treat a very common cause of blindness across the world.

scholarly journals Cell Therapy for Diabetic Retinopathy – A Work in Progress

2012 ◽  
Vol 06 (02) ◽  
pp. 125
Author(s):  
David Kent ◽  
Keyword(s):  
Diabetic Retinopathy ◽  
Cell Therapy ◽  
Cell Survival ◽  
Therapeutic Response ◽  
Vision Loss ◽  
Advanced Disease ◽  
Vascular Repair ◽  
Patients With Diabetes ◽  
Recipient Tissue

As the incidence of diabetes continues to rise worldwide, the challenge in preventing vision loss secondary to diabetic retinopathy (DR) remains a formidable one. Current treatments are only indicated in advanced disease when vision loss is imminent or has already occurred. In recent years, due to the discovery that postnatal vasculogenesis plays a role in vascular repair, there is increasing optimism that cell therapy using endothelial progenitor cells (EPCs) can be harnessed therapeutically for conditions such as DR. Although autologous EPC therapy offers promise for DR, EPCs from patients with diabetes are themselves dysfunctional while the diabetic milieu itself contributes further to this dysfunctionality. Additional research is also required to unravel the complete science of vasculogenesis and the role of EPCs in repair so that treatment can be optimised in terms of actual cell choice, pre-conditioning prior to transplantation, maximising cell survival in the recipient and preparation of the recipient tissue to ensure an adequate therapeutic response.

scholarly journals Diabetic Retinopathy—Update on Prevention Techniques, Present Therapies, and New Leads

2014 ◽  
Vol 07 (01) ◽  
pp. 54 ◽  
Author(s):  
Lauren M Marozas ◽  
Patrice E Fort ◽  
◽  
Keyword(s):  
Diabetic Retinopathy ◽  
Vision Loss ◽  
Developed Countries ◽  
Detection Methods ◽  
Retinal Microvasculature ◽  
Increased Risk ◽  
Patients With Diabetes ◽  
Combined Control ◽  
Working Age ◽  
Proactive Measures

Diabetic retinopathy is the major ocular complication associated with diabetes, and represents the leading cause of legal blindness in the working-age population of developed countries. Although classically diagnosed based on abnormalities of the retinal microvasculature, diabetic retinopathy is now widely recognized as a neurovascular disease. While all patients with diabetes are at increased risk for eye disease including diabetic retinopathy, proactive measures, and timely intervention can prevent or delay subsequent vision loss. Systemic management of diabetes by combined control of glycemia, blood pressure, and serum lipid levels remains the most important method of preventing diabetic retinopathy onset and progression. Once detected, surgical and medical interventions including photocoagulation, vitrectomy, and intravitral drug injection can help preserve vision. However, the need for improved detection methods and therapies that will allow earlier diagnosis and treatment remains apparent. This review summarizes current techniques for the prevention and intervention for diabetic retinopathy, and examines ongoing developments in the search for new endpoints and therapies as they apply to preventing vision loss associated with diabetes.

scholarly journals Trends in the epidemiology of diabetic retinopathy in Russian Federation according to the Federal Diabetes Register (2013–2016)

2018 ◽  
Vol 21 (4) ◽  
pp. 230-240 ◽  
Author(s):  
Dmitry V. Lipatov ◽  
Olga K. Vikulova ◽  
Anna V. Zheleznyakova ◽  
Mikhail А. Isakov ◽  
Elena G. Bessmertnaya ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Russian Federation ◽  
Vision Loss ◽  
Duration Of Diabetes ◽  
Frequency Of Use ◽  
Proliferative Stage ◽  
Patients With Diabetes ◽  
The Mean ◽  
Diabetes Register ◽  
Epidemiological Characteristics

Background: Diabetic retinopathy (DR) is one of the most common causes of blindness in patients with diabetes mellitus (DM) that is why its necessary to study the epidemiological characteristics of this complication. Aims: The aim of the study was to evaluate the epidemiological characteristics of DR and blindness in adult patients with type 1 (T1) and 2 (T2) diabetes in Russian Federation (RF) for period 201316years. Materials and methods: Database of Federal Diabetes register, 81st regions included in the online register. Indicators were estimated per 10,000 adult DM patients (18years). Results: In 2016 the DR prevalence in RF was T1 38,3%, T2 15,0%, with marked interregional differences: 2,666,1%, 1,146,4%, respectively. The DR prevalence within 20132016 years was: T1 3830,93805,6; T2 1586,01497,0. Trend of new DR cases/per year increased: T1 153,2187,8; T2 99,7114,9. The structure of new cases of DR in 2016: non-proliferative stage (T1 71,4%, T2 80,3%), pre-proliferative stage 16,4%, 13,8%, proliferative 12,1%, 5,8%, terminal 0,2%, 0,1%, respectively, these data indicated the earlier detection of DR. The mean age of DR diagnosis increased: T1 by 1,2 years, T2 by 2,6. The average DM duration of DR determine increased T1 9,613,1 years, T2 6,09,1. The prevalence of blindness tends to decrease: T1 92,390,8; T2 15,415,2/10.000 DM adults. The amount of new cases of blindness/per year increased: T1 4,34,6; T2 1,21,4. The mean age of blindness increased: T1 39,141,6 years, T2 64,467,4; the mean duration of diabetes before blindness occur (from the time of DM diagnosis) increased: T1 20,221,2 years, in T2 10,711,3. We observed growth of DR treatment (laser surgery, vitrectomy, anti-VEGF medication) but the frequency of use in T2 patients is about 2 times less than in T1. Conclusions: There was a decrease in the overall incidence of eye damage in diabetes (DR and blindness) in the analyzed period in RF. DR and blindness develops at advanced age and with a longer duration of diabetes. As the main directions of eye care development in diabetes it is necessary to standardize primary care in the regions, to unify the examination algorithms and methods of early diagnostic, to increase the continuity and interaction of endocrinologists and ophthalmologists in managing patients with diabetes in order to prevent the development of new cases of vision loss.

Cell Therapy for Diabetic Retinopathy—A Work in Progress

2012 ◽  
Vol 08 (01) ◽  
pp. 45
Author(s):  
David Kent ◽  
Keyword(s):  
Diabetic Retinopathy ◽  
Cell Therapy ◽  
Cell Survival ◽  
Therapeutic Response ◽  
Vision Loss ◽  
Advanced Disease ◽  
Vascular Repair ◽  
Patients With Diabetes ◽  
Recipient Tissue

As the incidence of diabetes continues to rise worldwide, the challenge in preventing vision loss secondary to diabetic retinopathy (DR) remains a formidable one. Current treatments are only indicated in advanced disease when vision loss is imminent or has already occurred. In recent years, due to the discovery that post-natal vasculogenesis plays a role in vascular repair, there has been increasing optimism that cell therapy using endothelial progenitor cells (EPCs) can be harnessed therapeutically for conditions such as DR. Although autologous EPC therapy offers promise for DR, EPCs from patients with diabetes are themselves dysfunctional, while the diabetic milieu itself contributes further to this dysfunctionality. Additional research is required to unravel the complete science of vasculogenesis and the role of EPCs in repair, so that treatment can be optimized in terms of actual cell choice, pre-conditioning prior to transplantation, maximizing cell survival in the recipient, and preparation of the recipient tissue to ensure an adequate therapeutic response.

scholarly journals Optical Coherence Tomography Angiography in Diabetes and Diabetic Retinopathy

2020 ◽  
Vol 9 (6) ◽  
pp. 1723 ◽  
Author(s):  
Jacqueline Chua ◽  
Ralene Sim ◽  
Bingyao Tan ◽  
Damon Wong ◽  
Xinwen Yao ◽  
...  
Keyword(s):  
Optical Coherence Tomography ◽  
Diabetic Retinopathy ◽  
Optical Coherence Tomography Angiography ◽  
Vision Loss ◽  
Longitudinal Design ◽  
Optical Coherence ◽  
Retinal Microvasculature ◽  
Retinal Capillary ◽  
Patients With Diabetes ◽  
Motion Contrast

Diabetic retinopathy (DR) is a common complication of diabetes mellitus that disrupts the retinal microvasculature and is a leading cause of vision loss globally. Recently, optical coherence tomography angiography (OCTA) has been developed to image the retinal microvasculature, by generating 3-dimensional images based on the motion contrast of circulating blood cells. OCTA offers numerous benefits over traditional fluorescein angiography in visualizing the retinal vasculature in that it is non-invasive and safer; while its depth-resolved ability makes it possible to visualize the finer capillaries of the retinal capillary plexuses and choriocapillaris. High-quality OCTA images have also enabled the visualization of features associated with DR, including microaneurysms and neovascularization and the quantification of alterations in retinal capillary and choriocapillaris, thereby suggesting a promising role for OCTA as an objective technology for accurate DR classification. Of interest is the potential of OCTA to examine the effect of DR on individual retinal layers, and to detect DR even before it is clinically detectable on fundus examination. We will focus the review on the clinical applicability of OCTA derived quantitative metrics that appear to be clinically relevant to the diagnosis, classification, and management of patients with diabetes or DR. Future studies with longitudinal design of multiethnic multicenter populations, as well as the inclusion of pertinent systemic information that may affect vascular changes, will improve our understanding on the benefit of OCTA biomarkers in the detection and progression of DR.

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