Vascular damage of retina in diabetic retinopathy and its treatment

Abstract

Retinopathy is a microvascular complication of diabetes that affects the peripheral retina, the macula or both, and is a leading cause of visual disability and blindness in people with diabetes. The severity of diabetic retinopathy (DR) ranges from nonproliferative and preproliferative to more severely proliferative DR, in which the abnormal growth of new vessels occurs. Total or partial vision loss can occur through a vitreous hemorrhage or retinal detachment, and central vision loss can occur through retinal vessel leakage or subsequent macular edema. Several mechanisms have been proposed to cause retinal and vasculature cellular damage in DR. A VEGF seems to play an important role in the development of complications associated with DR. Other mechanisms such as inflammation and PKC activity have been associated with its pathogenesis. Treatment includes surgical and nonsurgical therapies. Laser therapy is the standard of care for DR and prevents severe vision loss in patients. Vitrectomy is indicated in cases of worsening vision due to a nonclearing vitreous hemorrhage or tractional retinal detachment. Current option include anti-VEGF drugs, corticosteroids, PKC inhibitors, vitreolytic agents and many others with ongoing clinical trails. The objective of this review is to briefly describe the vascular damage of the retina in diabetes and its management.