Khan Amjad Ali, Rahmani Arshad Husain, Aldebasi Yousef Homood
Department of Basic Health Science, College of Applied Medical Science, Qassim University, Buraidah, Saudi Arabia.
Department of Medical Laboratories, College of Applied Medical Science, Qassim University, Buraidah, Saudi Arabia.
Curr Diabetes Rev. 2018;14(6):523-533. doi: 10.2174/1573399813666170915133253.
Diabetic Retinopathy is a leading cause of sight-threatening complication, which occurs due to a number of physiological and metabolic abnormalities during later stages of diabetes. Many of these abnormal changes are consistent with altered oxidative stress, inflammation, genetic set up, advanced glycation end products, and hematological changes. So the altered levels of different biomolecules related to these changes serve as important biomarkers to assess better evaluation and early treatment of this disease. Some treatments like laser therapy may be fast and specific but are more expensive, limited and can result in severe contraindications. Several other novel treatment strategies have been evolved recently besides classical approaches like control over hyperglycemia, hypertension, lipid profile to control diabetic retinopathy. These precise treatments are based on targeting the elevated biomarkers in retina. Such treatments include use of anti-VEGF therapy, intravitreal corticosteroids, gamigliptin and flavonoids.
The present review discusses the latest updates on diabetic retinopathy, common etiology, different biomarkers and current treatments. In conclusion, perfection and proper supervision of diabetes and early treatment of diabetic retinopathy are crucial in controlling the occurrence and severity of this disease.
糖尿病视网膜病变是导致视力威胁性并发症的主要原因,它在糖尿病后期因多种生理和代谢异常而发生。这些异常变化中的许多都与氧化应激改变、炎症、基因构成、晚期糖基化终产物以及血液学变化一致。因此,与这些变化相关的不同生物分子水平的改变可作为重要的生物标志物,以更好地评估和早期治疗这种疾病。一些治疗方法,如激光治疗,可能快速且具有特异性,但成本更高、有局限性且可能导致严重的禁忌症。除了像控制高血糖、高血压、血脂水平等经典方法来控制糖尿病视网膜病变外,最近还出现了其他几种新的治疗策略。这些精确的治疗方法基于针对视网膜中升高的生物标志物。此类治疗包括使用抗血管内皮生长因子(VEGF)疗法、玻璃体内注射皮质类固醇、伽格列汀和类黄酮。
本综述讨论了糖尿病视网膜病变的最新进展、常见病因、不同的生物标志物和当前的治疗方法。总之,完善且恰当的糖尿病管理以及糖尿病视网膜病变的早期治疗对于控制该疾病的发生和严重程度至关重要。