Vascular Complications and Diabetes: Current Therapies and Future Challenges
Diabetic retinal complications, including macular edema (DME) and proliferative diabetic retinopathy (PDR), are the leading cause of new cases of blindness among adults aged 20–74. Chronic hyperglycemia, considered the underlying cause of diabetic retinopathy, is thought to act first through violati...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Journal of Ophthalmology |
| Online Access: | http://dx.doi.org/10.1155/2012/209538 |
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| author | Abbott L. Willard Ira M. Herman |
| author_facet | Abbott L. Willard Ira M. Herman |
| author_sort | Abbott L. Willard |
| collection | DOAJ |
| description | Diabetic retinal complications, including macular edema (DME) and proliferative diabetic retinopathy (PDR), are the leading cause of new cases of blindness among adults aged 20–74. Chronic hyperglycemia, considered the underlying cause of diabetic retinopathy, is thought to act first through violation of the pericyte-endothelial coupling. Disruption of microvascular integrity leads to pathologic consequences including hypoxia-induced imbalance in vascular endothelial growth factor (VEGF) signaling. Several anti-VEGF medications are in clinical trials for use in arresting retinal angiogenesis arising from DME and PDR. Although a review of current clinical trials shows promising results, the lack of large prospective studies, head-to-head therapeutic comparisons, and potential long-term and systemic adverse events give cause for optimistic caution. Alternative therapies including targeting pathogenic specific angiogenesis and mural-cell-based therapeutics may offer innovative solutions for currently intractable clinical problems. This paper describes the mechanisms behind diabetic retinal complications, current research supporting anti-VEGF medications, and future therapeutic directions. |
| format | Article |
| id | doaj-art-4eda3433243b40d6a06ec9e1ced4ff60 |
| institution | Kabale University |
| issn | 2090-004X 2090-0058 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Ophthalmology |
| spelling | doaj-art-4eda3433243b40d6a06ec9e1ced4ff602025-08-20T03:36:32ZengWileyJournal of Ophthalmology2090-004X2090-00582012-01-01201210.1155/2012/209538209538Vascular Complications and Diabetes: Current Therapies and Future ChallengesAbbott L. Willard0Ira M. Herman1Graduate Program in Cellular and Molecular Physiology, Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, MA 02111, USAGraduate Program in Cellular and Molecular Physiology, Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, MA 02111, USADiabetic retinal complications, including macular edema (DME) and proliferative diabetic retinopathy (PDR), are the leading cause of new cases of blindness among adults aged 20–74. Chronic hyperglycemia, considered the underlying cause of diabetic retinopathy, is thought to act first through violation of the pericyte-endothelial coupling. Disruption of microvascular integrity leads to pathologic consequences including hypoxia-induced imbalance in vascular endothelial growth factor (VEGF) signaling. Several anti-VEGF medications are in clinical trials for use in arresting retinal angiogenesis arising from DME and PDR. Although a review of current clinical trials shows promising results, the lack of large prospective studies, head-to-head therapeutic comparisons, and potential long-term and systemic adverse events give cause for optimistic caution. Alternative therapies including targeting pathogenic specific angiogenesis and mural-cell-based therapeutics may offer innovative solutions for currently intractable clinical problems. This paper describes the mechanisms behind diabetic retinal complications, current research supporting anti-VEGF medications, and future therapeutic directions.http://dx.doi.org/10.1155/2012/209538 |
| spellingShingle | Abbott L. Willard Ira M. Herman Vascular Complications and Diabetes: Current Therapies and Future Challenges Journal of Ophthalmology |
| title | Vascular Complications and Diabetes: Current Therapies and Future Challenges |
| title_full | Vascular Complications and Diabetes: Current Therapies and Future Challenges |
| title_fullStr | Vascular Complications and Diabetes: Current Therapies and Future Challenges |
| title_full_unstemmed | Vascular Complications and Diabetes: Current Therapies and Future Challenges |
| title_short | Vascular Complications and Diabetes: Current Therapies and Future Challenges |
| title_sort | vascular complications and diabetes current therapies and future challenges |
| url | http://dx.doi.org/10.1155/2012/209538 |
| work_keys_str_mv | AT abbottlwillard vascularcomplicationsanddiabetescurrenttherapiesandfuturechallenges AT iramherman vascularcomplicationsanddiabetescurrenttherapiesandfuturechallenges |