Update on the Effects of Antioxidants on Diabetic Retinopathy: In Vitro Experiments, Animal Studies and Clinical Trials.

Jose Javier Garcia-Medina,Ricardo P Casaroli-Marano,Ricardo P Casaroli-Marano,Ricardo P Casaroli-Marano,Ricardo P Casaroli-Marano,Ricardo P Casaroli-Marano,Elena Rubio-Velazquez,Elisa Foulquie-Moreno,Vicente Zanon-Moreno,Monica Del-Rio-Vellosillo,Maria Dolores Pinazo-Duran

doi:10.3390/antiox9060561

Abstract

Current therapies for diabetic retinopathy (DR) incorporate blood glucose and blood pressure control, vitrectomy, photocoagulation, and intravitreal injections of anti-vascular endothelial growth factors or corticosteroids. Nonetheless, these techniques have not been demonstrated to completely stop the evolution of this disorder. The pathophysiology of DR is not fully known, but there is more and more evidence indicating that oxidative stress is an important mechanism in the progression of DR. In this sense, antioxidants have been suggested as a possible therapy to reduce the complications of DR. In this review we aim to assemble updated information in relation to in vitro experiments, animal studies and clinical trials dealing with the effect of the antioxidants on DR.

Highlights

Diabetic retinopathy (DR) is one of the most frequent causes of blindness in the adult and elderly population worldwide [1]
There was no correlation among the serum, aqueous humor and vitreous humor levels of vitamin C in the proliferative diabetic retinopathy (PDR) group. These findings suggest that ocular factors could be relevant in the pathogenesis of PDR and open new strategies and routes of administration of the treatment [133]
The studies examined in this survey suggest that a number of antioxidants may prevent or alleviate the deleterious effects of hyperglycaemic environment in cultured tissues, or the complications of diabetic retinopathy (DR)

Summary

Introduction

Diabetic retinopathy (DR) is one of the most frequent causes of blindness in the adult and elderly population worldwide [1]. Antioxidants 2020, 9, 561 membrane, the leakage of fluid and macromolecules from the vessels, and neovascularization [3,4] All these phenomena imply the damage of non-vascular cells of the retina such as neuronal and glial cells, with deleterious implications for visual function due to macular edema, vitreous hemorrhage or tractional retinal detachment. These events have been associated directly with oxidative stress [3,4]. A number of studies dealing with retinal cells cultured under hyperglycaemic conditions, animal models of DR and clinical trials with diabetic patients have been performed to test the effect of different antioxidants, alone or in combination, on the functional or structural alterations of DR

In Vitro Experiments

Animal Studies

Clinical Studies

Conclusions