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Angiogenesis in diabetic retinopathy: a history of accomplishment, discovery and promise

  • Lloyd Paul Aiello
Chapter

Abstract

Current theory holds that in diabetic retinopathy, retinal hypoxia stimulates production or increased activity by the retina of angiogenic growth factors. Angiogenesis resulting in vitreous hemorrhage and retinal traction are components of diabetic retinopathy that lead to blindness in one-half of those untreated within five years. Identification of specific angiogenesis promoting substances will permit antiangiogenic treatment strategies. Current antiangiogenic therapies for proliferative diabetic retinopathy require destruction of viable retinal tissue by laser photocoagulation or localized cryotherapy. Vascular endothelial growth factor/vasopermeability factor (VEGF) produced by many ocular cell types including retinal pigment epithelial cells is the candidate compound that best fits the model of hypoxemia-induced angiogenesis. Elevated concentrations of VEGF have been found in both vitreous and aqueous fluid samples of patients with active proliferative diabetic retinopathy but low in control patients and in diabetic subjects without retinopathy. A fascinating and promising approach, based on altering the molecular biology of retinal cells, to blunting proliferative diabetic retinopathy is described. An extraordinary 17 different angiogenesis inhibitors manufactured by over 120 biotechnology and pharmaceutical companies are in clinical trial. The race to block retinal angiogenesis by pharmacologic intervention will benefit diabetic individuals no matter who wins.

Keywords

Vascular Endothelial Growth Factor Diabetic Retinopathy Retinal Pigment Epithelial Cell Diabetic Macular Edema Proliferative Diabetic Retinopathy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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© Springer Science+Business Media Dordrecht 1998

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  • Lloyd Paul Aiello

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