The neurovascular unit and the pathophysiologic basis of diabetic retinopathy

• Published in: Graefe's archive for clinical and experimental ophthalmology Vol. 255; no. 1; pp. 1 - 6
• Main Authors: Gardner, Thomas W., Davila, Jose R.
• Format: Journal Article Book Review
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-01-2017; Springer Nature B.V
• Subjects: Diabetic retinopathy; Diabetic Retinopathy - complications; Diabetic Retinopathy - diagnosis; Disease Progression; Humans; Medicine; Medicine & Public Health; Ophthalmology; Retina - pathology; Retinal Neovascularization - diagnosis; Retinal Neovascularization - etiology; Review Article; Tomography, Optical Coherence - methods; Diabetic retinopathy; Frequency-doubling perimetry; Sensory neuropathy; Neurovascular unit; Spectral domain optical coherence tomography (SD-OCT)
• ISSN: 0721-832X; 1435-702X
• DOI: 10.1007/s00417-016-3548-y

Purpose
To relate the concept of the retinal neurovascular unit and its alterations in diabetes to the pathophysiology of diabetic retinopathy.
Methods
Case illustrations and conceptual frameworks are presented that illustrate adaptive and maladaptive “dis-integration” of the retinal neurovascular unit with the progression of diabetes.
Results
Retinopathy treatment should address pathophysiologic processes rather than pathologic lesions as is current practice.
Conclusions
Future improvements in the treatment of diabetic retinopathy requires deeper understanding of the cellular and molecular changes induced by diabetes, coupled with the use of quantitative phenotyping methods that assess the pathophysiologic processes.