title: The progress in understanding and treatment of diabetic retinopathy.
abstract: Diabetic retinopathy is the most frequently occurring complication of diabetes mellitus and remains a leading cause of vision loss globally. Its aetiology and pathology have been extensively studied for half a century, yet there are disappointingly few therapeutic options. Although some new treatments have been introduced for diabetic macular oedema (DMO) (e.g. intravitreal vascular endothelial growth factor inhibitors ('anti-VEGFs') and new steroids), up to 50% of patients fail to respond. Furthermore, for people with proliferative diabetic retinopathy (PDR), laser photocoagulation remains a mainstay therapy, even though it is an inherently destructive procedure. This review summarises the clinical features of diabetic retinopathy and its risk factors. It describes details of retinal pathology and how advances in our understanding of pathogenesis have led to identification of new therapeutic targets. We emphasise that although there have been significant advances, there is still a pressing need for a better understanding basic mechanisms enable development of reliable and robust means to identify patients at highest risk, and to intervene effectively before vision loss occurs.
authors: Centre for Experimental Medicine, Queen's University Belfast, Northern Ireland, UK. Electronic address: a.stitt@qub.ac.uk.
authors: Alan W
authors: AW
authors: Stitt
authors: Centre for Experimental Medicine, Queen's University Belfast, Northern Ireland, UK.
authors: Timothy M
authors: TM
authors: Curtis
authors: Centre for Experimental Medicine, Queen's University Belfast, Northern Ireland, UK.
authors: Mei
authors: M
authors: Chen
authors: Centre for Experimental Medicine, Queen's University Belfast, Northern Ireland, UK.
authors: Reinhold J
authors: RJ
authors: Medina
authors: Centre for Public Health, Queen's University Belfast, Northern Ireland, UK.
authors: Gareth J
authors: GJ
authors: McKay
authors: Centre for Experimental Medicine, Queen's University Belfast, Northern Ireland, UK; NHMRC Clinical Trials Centre, Sydney Medical School, The University of Sydney, Australia.
authors: Alicia
authors: A
authors: Jenkins
authors: Centre for Experimental Medicine, Queen's University Belfast, Northern Ireland, UK.
authors: Thomas A
authors: TA
authors: Gardiner
authors: Centre for Experimental Medicine, Queen's University Belfast, Northern Ireland, UK.
authors: Timothy J
authors: TJ
authors: Lyons
authors: Department of Medicine and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany.
authors: Hans-Peter
authors: HP
authors: Hammes
authors: Institut de Recerca Hospital Universitari Vall d'Hebron (VHIR), Barcelona, Spain.
authors: Rafael
authors: R
authors: Simó
authors: Centre for Experimental Medicine, Queen's University Belfast, Northern Ireland, UK.
authors: Noemi
authors: N
authors: Lois
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000818:Animals; D000068258:Bevacizumab / Q000627:therapeutic use; D003930:Diabetic Retinopathy / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D058449:Intravitreal Injections; D017075:Laser Coagulation; D000069579:Ranibizumab / Q000627:therapeutic use; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D020533:Angiogenesis Inhibitors; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D000069579:Ranibizumab
keywords: Diabetes; Diabetic macular oedema; Diabetic retinopathy; Pathogenesis; Retina