Abstract
Diabetic retinopathy (DR) is one of the most frequent microvascular complications of diabetes. A large body of evidence supports the role of inflammation in the development and progression of DR. Currently, DR is diagnosed based on the presence of morphological lesions detected on fundus examination. Yet, there are other laboratory or imaging biomarker whose alteration precede DR lesions. This chapter will first briefly explain the role of inflammation in DR pathogenesis and will analyze the molecules involved. Further, it will discuss significant and recent studies that analyzed local laboratory or imaging inflammatory biomarkers in different DR stages. It will then focus on several potential inflammation-targeting therapies which proved to be effective in animal or human studies. Validation of these reviewed biomarkers would allow the identification of patients who do not respond to the current available treatment and could benefit from an adjunctive therapy.
Highlights
Diabetus mellitus (DM) is an important public health issue, with a constantly growing prevalence from 4.7% in 1980 to 8.5% in 2014 [1]
In this review we provide an overview of several local inflammatory biomarkers of Diabetic retinopathy (DR) laboratory and retinal imaging together with anti-inflammatory therapeutic options
monocyte chemoattractant protein-1 (MCP-1) level in aqueous humor (AH) is believed to be a predictor for a worse visual acuity outcome of proliferative diabetic retinopathy (PDR) patients after vitrectomy, while there was no significant correlation between VEGF levels and BCVA, as noted by Lei et al [39]
Summary
Diabetus mellitus (DM) is an important public health issue, with a constantly growing prevalence from 4.7% in 1980 to 8.5% in 2014 [1]. Most type 1 DM (T1DM) patients develop DR only after 5 years or even more from the onset of DM, but after 20- year history of disease, 99% present a form of DR [3]. For type 2 DM (T2DM) patients, DR may be present even from the diagnosis, while after 20 years of T2DM, 60% of the patients develop DR [3]. DR staging is performed depending on the presence of clinical ocular biomarkers, such as microaneurysms, hemorrhages, soft or hard exudates, macular oedema and new vessels. A large body of evidence supports the role of inflammation in the development and Diabetic Eye Disease - From Therapeutic Pipeline to the Real World progression of DR. In this review we provide an overview of several local inflammatory biomarkers of DR laboratory and retinal imaging together with anti-inflammatory therapeutic options
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