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Epidemiology, Risk Factors, and Pathophysiology of Diabetic Retinopathy

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Clinical Strategies in the Management of Diabetic Retinopathy

Abstract

Diabetic retinopathy is a neurovascular complication of diabetes and is the leading cause of new cases of legal blindness in the United States. Diabetic retinopathy may become the leading cause of visual impairment globally, including low-income and middle-income countries. Some risk factors for diabetic retinopathy include long duration of diabetes mellitus, poor glycemic control, uncontrolled hypertension, obesity, ethnicity (e.g., higher risk in South Asians and Hispanics vs. Whites), low socioeconomic status, and genetic risk factors. The pathophysiology of diabetic retinopathy is complex and involves oxidative stress and inflammation, both of which result in microvascular and neuronal dysfunction. Neuronal dysfunction precedes the clinically observable microvascular complications of microaneurysms, hemorrhage, retinal edema, vascular occlusion, venous beading and loops, retinal neovascularization, vitreous hemorrhage, and fibrovascular proliferation with retinal detachment. A number of cytokines play important roles in disease pathogenesis including vascular endothelial growth factor, tumor necrosis factor-alpha, and interleukin-1b. In model systems, some of the inflammatory mediators remain elevated even after blood glucose is normalized, which may explain the clinical observation that diabetic retinopathy can remain active even when blood glucose is controlled. As the pathophysiology of the disease is better defined, more disease targets will be identified for drug development.

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  1. Institute of Ophthalmology and Visual Science, Rutgers-New Jersey Medical School, Rutgers University, Newark, NJ, USA

    Neelakshi Bhagat & Marco Attilio Zarbin

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  1. Neelakshi Bhagat
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  2. Marco Attilio Zarbin
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Correspondence to Neelakshi Bhagat .

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Editors and Affiliations

  1. Department of Ophthalmology, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy

    Francesco Bandello

  2. Institute of Ophthalmology and Visual Science, Rutgers-New Jersey Medical School, Rutgers University, Newark, NJ, USA

    Marco Attilio Zarbin

  3. Department of Ophthalmology, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy

    Rosangela Lattanzio

  4. Department of Ophthalmology, Vita-Salute University, San Raffaele Scientific Institute, Milan, Italy

    Ilaria Zucchiatti

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Bhagat, N., Zarbin, M.A. (2019). Epidemiology, Risk Factors, and Pathophysiology of Diabetic Retinopathy. In: Bandello, F., Zarbin, M., Lattanzio, R., Zucchiatti, I. (eds) Clinical Strategies in the Management of Diabetic Retinopathy. Springer, Cham. https://doi.org/10.1007/978-3-319-96157-6_1

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