Molecular Pathogenesis and Therapeutics in Retinopathy

Dear Colleagues,

Diabetic retinopathy (DR) is the most common and severe microvascular complication of diabetes mellitus (DM) that may lead to vision damage to the retina and remains the leading cause of blindness in the most developed countries. Current treatments, including lasers, anti-vascular endothelial growth factor (VEGF) therapy, steroids, and vitrectomy, target the late stages of DR, when vision has already been significantly affected. Therefore, it is of fundamental importance to study the pathogenesis of the early stages of DR in order to identify novel and more efficient preventive and interventional strategies. In the last few years, the concept of DR as a microvascular disease has evolved, in that it is now considered a more complex diabetic complication, in which retinal neurodegeneration (RN) plays a significant role. A special emphasis was placed on the pathophysiology of the retinal neurovascular unit (NVU), examining the contributions of the microvascular and neural elements that changed the traditional view of this disease. The components of the NVU include different neural cell types (i.e., ganglion cells, amacrine cells, horizontal cells, and bipolar cells), glia (e.g., Müller cells and astrocytes), professional immune cells (e.g., microglia and perivascular macrophages), and vascular cells (e.g., endothelial cells and pericytes). The diabetic milieu is related to the impairment of the NVU, which is characterized by RN and early microvascular alterations. Therefore, RN currently represents an early component of DR, occurring earlier than clinically identifiable microvascular damage, and can be considered a real form of neuropathy.  

This Special Issue invites researchers to submit molecular and clinical research and review articles that address the progress and current knowledge on the pathogenesis of this disease, the impact of glucose metabolism on retinal neurodegeneration, and therapeutic approaches. Moreover, with this Special Issue, we hope to shed light on the possible relationship between neural–retina alterations and diabetic peripheral or central neuropathy. 

Dr. Fabiana Picconi
Guest Editor

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• retinal neurodegeneration
• retinal neurovascular unit
• diabetic retinopathy
• diabetic neuropathy
• diabetic milieu
• glucose variability