Abstract
Vision-threatening retinal diseases affect millions of people worldwide, representing an important public health issue (high social cost) for both technologically advanced and new-industrialized countries. Overall RD group comprises the retinitis pigmentosa, the age-related macular degeneration (AMD), the diabetic retinopathy (DR), and idiopathic epiretinal membrane formation. Endocrine, metabolic, and even lifestyles risk factors have been reported for these age-linked conditions that represent a “public priority” also in this COVID-19 emergency. Chronic inflammation and neurodegeneration characterize the disease evolution, with a consistent vitreoretinal interface impairment. As the vitreous chamber is significantly involved, the latest diagnostic technologies of imaging (retina) and biomarker detection (vitreous) have provided a huge input at both medical and surgical levels. Complement activation and immune cell recruitment/infiltration as well as detrimental intra/extracellular deposits occur in association with a reactive gliosis. The cell/tissue aging route shows a specific signal path and biomolecular profile characterized by the increased expression of several glial-derived mediators, including angiogenic/angiostatic, neurogenic, and stress-related factors (oxidative stress metabolites, inflammation, and even amyloid formation). The possibility to access vitreous chamber by collecting vitreous reflux during intravitreal injection or obtaining vitreous biopsy during a vitrectomy represents a step forward for an individualized therapy. As drug response and protein signature appear unique in each single patient, therapies should be individualized. This review addresses the current knowledge about biomarkers and pharmacological targets in these vitreoretinal diseases. As vitreous fluids might reflect the early stages of retinal sufferance and/or late stages of neurodegeneration, the possibility to modulate intravitreal levels of growth factors, in combination to anti-VEGF therapy, would open to a personalized therapy of retinal diseases.
Highlights
A recent evaluation of the current prevalence and pattern of retinal diseases (RD) in industrialized and nonindustrialized countries highlights that RD are increasing worldwide representing a serious problem even under COVID-19 emergency.RD group includes the retinitis pigmentosa, the age-related macular degeneration, the diabetic retinopathy, and the idiopathic epiretinal membrane formations
This review addresses the current knowledge about potential candidate biomarkers and pharmacological targets in these vitreoretinal diseases
As vitreous fluids might reflect the early stages of retinal sufferance and/or late stages of degeneration, the possibility to modulate intravitreal levels of growth factors will be discussed as an additional way to improve treatment approaches, most of them in combination to anti-Vascular Endothelial Growth Factor (VEGF) therapy
Summary
A recent evaluation of the current prevalence and pattern of retinal diseases (RD) in industrialized and nonindustrialized countries highlights that RD are increasing worldwide representing a serious problem even under COVID-19 emergency.RD group includes the retinitis pigmentosa, the age-related macular degeneration, the diabetic retinopathy, and the idiopathic epiretinal membrane formations. Biomarkers in Retinal Diseases several risk factors (endocrine, metabolic, and even lifestyles influencers) have been reported for these age-linked conditions that represent a “public priority” as worldwide population is more long-lived and its life expectancy is increasing.
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