title: Pathophysiology and treatment of diabetic retinopathy.
abstract: In the past years, the management of diabetic retinopathy (DR) relied primarily on a good systemic control of diabetes mellitus, and as soon as the severity of the vascular lesions required further treatment, laser photocoagulation or vitreoretinal surgery was done to the patient. Currently, even if the intensive metabolic control is still mandatory, a variety of different clinical strategies could be offered to the patient. The recent advances in understanding the complex pathophysiology of DR allowed the physician to identify many cell types involved in the pathogenesis of DR and thus to develop new treatment approaches. Vasoactive and proinflammatory molecules, such as vascular endothelial growth factor (VEGF), play a key role in this multifactorial disease. Current properly designed trials, evaluating agents targeting VEGF or other mediators, showed benefits in the management of DR, especially when metabolic control is lacking. Other agents, directing to the processes of vasopermeability and angiogenesis, are under investigations, giving more hope in the future management of this still sight-threatening disease.
authors.affiliation: Department of Ophthalmology, Scientific Institute San Raffaele, University Vita-Salute, Milan, Italy. bandello.francesco@hsr.it
authors.forename: Francesco
authors.initials: F
authors.lastname: Bandello
authors.forename: Rosangela
authors.initials: R
authors.lastname: Lattanzio
authors.forename: Ilaria
authors.initials: I
authors.lastname: Zucchiatti
authors.forename: Claudia
authors.initials: C
authors.lastname: Del Turco
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000494:pharmacology; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000276:immunology / Q000503:physiopathology*; D006801:Humans; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors / Q000276:immunology
chemical_list: D000893:Anti-Inflammatory Agents; D042461:Vascular Endothelial Growth Factor A