Neurodegeneration in the diabetic eye: new insights and therapeutic perspectives

Trends Endocrinol Metab. 2014 Jan;25(1):23-33. doi: 10.1016/j.tem.2013.09.005. Epub 2013 Nov 1.


Diabetic retinopathy (DR), one of the leading causes of preventable blindness, has been considered a microcirculatory disease of the retina. However, there is emerging evidence to suggest that retinal neurodegeneration is an early event in the pathogenesis of DR, which participates in the development of microvascular abnormalities. Therefore, the study of the underlying mechanisms leading to neurodegeneration and the identification of the mediators in the crosstalk between neurodegeneration and microangiopathy will be essential for the development of new therapeutic strategies. In this review, an updated discussion of the mechanisms involved in neurodegeneration, as well as the link between neurodegeneration and microangiopathy, is presented. Finally, the therapeutic implications and new perspectives based on identifying those patients with retinal neurodegeneration are given.

Keywords: Diabetic retinopathy; diabetic microangiopathy; eye drops; neurodegeneration; neuroprotection; neurovascular unit.

Publication types

  • Review

MeSH terms

  • Animals
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Apoptosis
  • Diabetic Retinopathy / physiopathology*
  • Diabetic Retinopathy / therapy
  • Glutamic Acid / metabolism
  • Humans
  • Inflammation / pathology
  • Inflammation / physiopathology
  • Macular Degeneration / prevention & control
  • Microcirculation
  • Neurodegenerative Diseases / pathology
  • Neuroprotective Agents / therapeutic use*
  • Ranibizumab
  • Retina / metabolism
  • Retina / pathology
  • Retinal Vessels / pathology
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors


  • Antibodies, Monoclonal, Humanized
  • Neuroprotective Agents
  • Vascular Endothelial Growth Factor A
  • Glutamic Acid
  • Ranibizumab