Implications of Diabetes-Induced Altered Metabolites on Retinal Neurodegeneration
Diabetic retinopathy (DR) is one of the major complications of diabetic eye diseases,
causing vision loss and blindness worldwide. The concept of diabetic retinopathy has
evolved from microvascular disease into more complex neurovascular disorders. Early in
the disease progression of diabetes, the neuronal and glial cells are compromised before
any microvascular abnormalities clinically detected by the ophthalmoscopic examination.
This implies understanding the pathophysiological mechanisms at the early stage of
disease progression especially due to diabetes-induced metabolic alterations to damage
the neural retina so that early intervention and treatments options can be identified to
prevent and inhibit the progression of DR. Hyperglycemia has been widely considered
the major contributor to the progression of the retinal damage, even though tight control
of glucose does not seem to have a bigger effect on the incidence or progression of retinal
damage that leads to DR. Emerging evidence suggests that besides diabetes-induced
hyperglycemia, dyslipidemia and amino acid defects might be a major contributor to the
progression of early neurovascular retinal damage. In this review, we have discussed
recent advances in the alterations of key metabolites of carbohydrate, lipid, and amino
acids and their implications for neurovascular damage in DR.
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