Abstract
Most irreversible blindness observed with glaucoma and retina-related ocular diseases, including age-related macular degeneration and diabetic retinopathy, have their origin in the posterior segment of the eye, making their physiopathology both complex and interconnected. In addition to the age factor, these diseases share the same mechanism disorder based essentially on oxidative stress. In this context, the imbalance between the production of reactive oxygen species (ROS) mainly by mitochondria and their elimination by protective mechanisms leads to chronic inflammation. Oxidative stress and inflammation share a close pathophysiological process, appearing simultaneously and suggesting a relationship between both mechanisms. The biochemical end point of these two biological alarming systems is the release of different biomarkers that can be used in the diagnosis. Furthermore, oxidative stress, initiating in the vulnerable tissue of the posterior segment, is closely related to mitochondrial dysfunction, apoptosis, autophagy dysfunction, and inflammation, which are involved in each disease progression. In this review, we have analyzed (1) the oxidative stress and inflammatory processes in the back of the eye, (2) the importance of biomarkers, detected in systemic or ocular fluids, for the diagnosis of eye diseases based on recent studies, and (3) the treatment of posterior ocular diseases, based on long-term clinical studies.
Highlights
Age-related ocular diseases related to the posterior segment of the eye including glaucoma, age-related macular degeneration (AMD), and diabetic retinopathy (DR) share similar characteristics, which facilitates their diagnosis
The vascular dysfunction and neurodegeneration at the retina might be mediated by advanced glycation end products (AGEs), which are an oxidative stress-related biomarker that results from the reaction between reducing sugar with amino groups in proteins, lipids, or nucleic acids and is detected in the axons of retinal ganglion cells (RGCs) and retinal glial cells in glaucoma
The approach was to describe the role of oxidative stress as one of the first events in the inflammation cascade, thereby explaining how biomarkers of oxidative stress and inflammation are necessary to understand the physiopathology of main diseases and molecular crosstalk disorder that connect retinal blood vessels, retina, and retinal ganglion cells
Summary
Age-related ocular diseases related to the posterior segment of the eye including glaucoma, age-related macular degeneration (AMD), and diabetic retinopathy (DR) share similar characteristics, which facilitates their diagnosis. All of them are serious diseases, leading to irreversible blindness. Glaucoma is currently the most common cause of irreversible visual impairment. The three diseases present a complex pathophysiology, which is related to cellular senescence, oxidative stress, and the inflammatory pathway [4]. Oxidative stress is normally associated with the generation of reactive oxygen (ROS). ROS can react rapidly with nitric oxide (NO), generating RNS. These substances are considered as metabolites with a high capacity to oxidize proteins, lipids, and nucleic acids [5] and enhance autophagy and mitophagy processes [6], cell dysfunction, necrosis, apoptosis, and cell death [7,8].
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