Frudd Karen, Sivaprasad Sobha, Raman Rajiv, Krishnakumar Subramanian, Revathy Yeddula Rebecca, Turowski Patric
Institute of Ophthalmology, University College London, London, UK.
NIHR Moorfields Biomedical Research Centre, Moorfields Eye Hospital, London, UK.
Acta Ophthalmol. 2022 May;100(3):e648-e668. doi: 10.1111/aos.14954. Epub 2021 Jul 16.
With the increasing prevalence of diabetes in developing and developed countries, the socio-economic burden of diabetic retinopathy (DR), the leading complication of diabetes, is growing. Diabetic retinopathy (DR) is currently one of the leading causes of blindness in working-age adults worldwide. Robust methodologies exist to detect and monitor DR; however, these rely on specialist imaging techniques and qualified practitioners. This makes detecting and monitoring DR expensive and time-consuming, which is particularly problematic in developing countries where many patients will be remote and have little contact with specialist medical centres. Diabetic retinopathy (DR) is largely asymptomatic until late in the pathology. Therefore, early identification and stratification of vision-threatening DR (VTDR) is highly desirable and will ameliorate the global impact of this disease. A simple, reliable and more cost-effective test would greatly assist in decreasing the burden of DR around the world. Here, we evaluate and review data on circulating protein biomarkers, which have been verified in the context of DR. We also discuss the challenges and developments necessary to translate these promising data into clinically useful assays, to detect VTDR, and their potential integration into simple point-of-care testing devices.
随着糖尿病在发展中国家和发达国家的患病率不断上升，糖尿病的主要并发症——糖尿病视网膜病变（DR）的社会经济负担也在增加。糖尿病视网膜病变（DR）目前是全球劳动年龄成年人失明的主要原因之一。现已有成熟的方法来检测和监测DR；然而，这些方法依赖于专业的成像技术和合格的从业者。这使得检测和监测DR既昂贵又耗时，在发展中国家尤其成问题，因为那里的许多患者居住在偏远地区，与专业医疗中心接触很少。糖尿病视网膜病变（DR）在病理过程后期之前大多没有症状。因此，尽早识别和分层有视力威胁的糖尿病视网膜病变（VTDR）非常必要，这将减轻这种疾病对全球的影响。一种简单、可靠且更具成本效益的检测方法将极大地有助于减轻全球范围内DR的负担。在此，我们评估并综述了已在DR背景下得到验证的循环蛋白生物标志物的数据。我们还讨论了将这些有前景的数据转化为临床有用的检测方法以检测VTDR所必需面对的挑战和进展，以及它们潜在地整合到简单的即时检测设备中的情况。
