NEUROPROTECTION AS A THERAPEUTIC TARGET IN DIABETIC RETINOPATHY
Keywords:
Diabetic retinopathy. Neurodegeneration. Neuroprotection. Diabetic retinopathy treatment. Neurovascular connectionAbstract
Diabetic retinopathy (DR) is considered a microcirculatory disease of the retina. However, new data are emerging that suggest that retinal neurodegeneration is an early event in the pathogenesis of DR, which may precede the development of microcirculatory disorders that occur in DR, as well as participate in them. Therefore, studying the underlying mechanisms that lead to neurodegeneration will be essential for identifying new therapeutic targets in the early stages of DR. Elevated glutamate levels, oxidative stress, overexpression of the renin-angiotensin system, and activation of glycation end-product receptors play important roles in diabetic-induced retinal neurodegeneration. Finally, the balance between neurotoxic and neuroprotective factors is critical in determining the survival of retinal neurons. In this review, we focus on neurotrophic factors already synthesized by the retina under physiological conditions, and we also discuss current neuroprotective strategies and future directions for the treatment of DR.
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