The neurovascular unit and the pathophysiologic basis of diabetic retinopathy

Graefes Arch Clin Exp Ophthalmol. 2017 Jan;255(1):1-6. doi: 10.1007/s00417-016-3548-y. Epub 2016 Nov 10.


Purpose: To relate the concept of the retinal neurovascular unit and its alterations in diabetes to the pathophysiology of diabetic retinopathy.

Methods: Case illustrations and conceptual frameworks are presented that illustrate adaptive and maladaptive "dis-integration" of the retinal neurovascular unit with the progression of diabetes.

Results: Retinopathy treatment should address pathophysiologic processes rather than pathologic lesions as is current practice.

Conclusions: Future improvements in the treatment of diabetic retinopathy requires deeper understanding of the cellular and molecular changes induced by diabetes, coupled with the use of quantitative phenotyping methods that assess the pathophysiologic processes.

Keywords: Diabetic retinopathy; Frequency-doubling perimetry; Neurovascular unit; Sensory neuropathy; Spectral domain optical coherence tomography (SD-OCT).

Publication types

  • Review

MeSH terms

  • Diabetic Retinopathy / complications
  • Diabetic Retinopathy / diagnosis*
  • Disease Progression
  • Humans
  • Retina / pathology*
  • Retinal Neovascularization / diagnosis*
  • Retinal Neovascularization / etiology
  • Tomography, Optical Coherence / methods*