Fathima Sarah, Prokopiou Ekatherine, Georgiou Tassos
Department of Basic and Clinical Sciences, University of Nicosia Medical School, 2414 Nicosia, Cyprus.
Ophthalmos Research and Educational Institute, 2417 Nicosia, Cyprus.
Front Biosci (Landmark Ed). 2023 Jul 27;28(7):153. doi: 10.31083/j.fbl2807153.
Diabetic retinopathy (DR) is a common microvascular complication of type 2 Diabetes Mellitus (T2DM) that can have vision-threatening consequences, particularly if it advances to the proliferative stage and is left untreated. Owing to the central role of hyperglycemia-induced oxidative stress, multiple anti-oxidants have been investigated for their therapeutic value. However, there is a lack of substantial data to support the use of any of the compounds tested so far. Omega-3 polyunsaturated fatty acids (PUFAs), namely docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), have received much acclaim for their positive impact on cardiovascular health outcomes. The anti-oxidative, anti-inflammatory and neuroprotective properties of PUFAs also make them promising therapeutic and preventive agents for DR. The current evidence is derived mainly from and animal studies and provides some insight into the underlying mechanisms involved. These fatty acids are capable of direct anti-oxidative and anti-inflammatory effects. They also concomitantly promote intrinsic defense mechanisms and recovery, particularly of photoreceptor neurons. Hence, dietary supplementation with PUFAs, mainly from marine sources, can halt and reverse the retinal damage seen in DR. Furthermore, clinical trials have reported improved vision and quality of life in DR patients after supplementation. However, a major limitation of these trials is the use of nutraceutical formulations in which omega-3 PUFAs are combined with other anti-oxidant compounds, thereby preventing the evaluation of omega-3 as standalone treatment. Although the results of experimental studies to date have been promising, more clinical trials are required to determine the full extent of benefits in patients with DR.
糖尿病性视网膜病变（DR）是2型糖尿病（T2DM）常见的微血管并发症，可能会导致视力受损，尤其是病情发展到增殖期且未得到治疗时。由于高血糖诱导的氧化应激起核心作用，人们对多种抗氧化剂的治疗价值进行了研究。然而，目前缺乏充分的数据支持使用迄今为止所测试的任何一种化合物。ω-3多不饱和脂肪酸（PUFAs），即二十二碳六烯酸（DHA）和二十碳五烯酸（EPA），因其对心血管健康结果的积极影响而备受赞誉。PUFAs的抗氧化、抗炎和神经保护特性也使其成为DR有前景的治疗和预防药物。目前的证据主要来自于 和动物研究，为其中涉及的潜在机制提供了一些见解。这些脂肪酸具有直接的抗氧化和抗炎作用。它们还能同时促进内在防御机制和恢复，尤其是感光神经元的恢复。因此，饮食中补充主要来自海洋来源的PUFAs可以阻止并逆转DR中出现的视网膜损伤。此外，临床试验报告称，补充后DR患者的视力和生活质量有所改善。然而，这些试验的一个主要局限性是使用了营养制剂，其中ω-3 PUFAs与其他抗氧化化合物结合，从而无法评估ω-3作为单一治疗方法的效果。尽管迄今为止的实验研究结果很有前景，但仍需要更多的临床试验来确定DR患者的全部益处。
