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Diabetic retinal neurodegeneration as a form of diabetic retinopathy

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Abstract

Purpose

To review the evidence supporting diabetic retinal neurodegeneration (DRN) as a form of diabetic retinopathy.

Method

Review of literature.

Results

DRN is recognized to be a part of retinopathy in patients with diabetes mellitus (DM), in addition to the well-established diabetic retinal vasculopathy (DRV). DRN has been noted in the early stages of DM, before the onset of clinically evident diabetic retinopathy. The occurrence of DRN has been confirmed in animal models of DM, histopathological examination of donor’s eyes from diabetic individuals and assessment of neural structure and function in humans. DRN involves alterations in retinal ganglion cells, photoreceptors, amacrine cells and bipolar cells, and is thought to be driven by glutamate, oxidative stress and dysregulation of neuroprotective factors in the retina. Potential therapeutic options for DRN are under evaluation.

Conclusions

Literature is divided on the temporal relation between DRN and DRV, with evidence of both precedence and simultaneous occurrence. The relationship between DRN and multi-system neuropathy in DM is yet to be evaluated critically.

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Funding

The authors have not received grant support or research funding and do not have any proprietary interests in the materials described in the article; Dr BT gets general research support from the Hyderabad Eye Research Foundation and India Alliance CRTP grant.

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Authors and Affiliations

  1. Department of Ophthalmology, All India Institute of Medical Sciences-Bhopal, Bhopal, India

    Deepak Soni

  2. Department of Vitreo-Retina, Sankara Eye Hospital, Shivamogga, India

    Pradeep Sagar

  3. Smt. Kanuri Santhamma Center for Vitreoretinal Diseases, L. V. Prasad Eye Institute, Hyderabad, India

    Brijesh Takkar

  4. Indian Health Outcomes, Public Health and Economics Research (IHOPE) Centre, L. V. Prasad Eye Institute, Hyderabad, India

    Brijesh Takkar

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  1. Deepak Soni
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  2. Pradeep Sagar
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Correspondence to Brijesh Takkar.

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Soni, D., Sagar, P. & Takkar, B. Diabetic retinal neurodegeneration as a form of diabetic retinopathy. Int Ophthalmol 41, 3223–3248 (2021). https://doi.org/10.1007/s10792-021-01864-4

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