Diabetic retinopathy: loss of neuroretinal adaptation to the diabetic metabolic
Authors Abcouwer SF, Gardner TW
Submitted By Submitted Externally on 4/15/2014
Status Published
Journal Annals of the New York Academy of Sciences
Year 2014
Date Published 4/1/2014
Volume : Pages 1311 : 174 - 190
PubMed Reference 24673341
Abstract Diabetic retinopathy (DR) impairs vision of patients with type 1 and type 2
diabetes, associated with vascular dysfunction and occlusion, retinal edema,
hemorrhage, and inappropriate growth of new blood vessels. The recent success of
biologic treatments targeting vascular endothelial growth factor (VEGF)
demonstrates that treating the vascular aspects in the later stages of the
disease can preserve vision in many patients. It would also be highly desirable
to prevent the onset of the disease or arrest its progression at a stage
preceding the appearance of overt microvascular pathologies. The progression of
DR is not necessarily linear but may follow a series of steps that evolve over
the course of multiple years. Abundant data suggest that diabetes affects the
entire neurovascular unit of the retina, with an early loss of neurovascular
coupling, gradual neurodegeneration, gliosis, and neuroinflammation occurring
before observable vascular pathologies. In this article, we consider the
pathology of DR from the point of view that diabetes causes measurable
dysfunctions in the complex integral network of cell types that produce and
maintain human vision.

Investigators with authorship
Steven AbcouwerUniversity of Michigan-Ann Arbor