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Molecular Insights and Treatment of Diabetic Retinopathy

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 8931

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Prof. Dr. Sayon Roy

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Guest Editor

Department of Ophthalmology, Boston University School of Medicine, Boston, MA 02118, USA
Interests: diabetic retinopathy; structural and functional changes in the diabetic retina; cell-cell communication; mitochondrial dysfunction

Special Issue Information

Dear Colleagues,

The worldwide increase in the diabetic population predicts a significant rise in the number of individuals with diabetes-related retinal diseases. An overwhelming cause of vision loss in diabetic retinopathy is related to excess vascular permeability, the development of macular edema, and uncontrolled neovascularization. Despite the use of laser photocoagulation, and available therapeutics, the majority of patients do not fully recover from vision loss. Although anti-VEGF approaches work well they are not always successful in DR patients. Therefore, identifying alternative or supplemental therapeutic approaches for DR treatment is acutely needed. Research into areas involving vascular structural alterations and blood retinal barrier characteristics has uncovered significant underlying factors that participate in these pathogenetic changes. This Special Issue will highlight current insights underlying molecular mechanisms and novel approaches towards better understanding and treatment of DR.

Prof. Dr. Sayon Roy
Guest Editor

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Keywords

Vascular Permeability
Macular Edema
Novel Approaches to DR Treatment
Lysyl Oxidase
Extracellular Matrix
Structural Abnormalities
Functional Abnormalities
Endothelial cells
Pericytes
Müller Cells
Photoreceptors
Astrocytes

Published Papers (4 papers)

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Research

8 pages, 235 KiB

Open AccessArticle

Arginase Gene Polymorphism Increases Risk of Diabetic Retinopathy in Type 2 Diabetes Mellitus Patients

by Monika Buraczynska and Izabela Zakrocka

J. Clin. Med. 2021, 10(22), 5407; https://doi.org/10.3390/jcm10225407 - 19 Nov 2021

Cited by 5 | Viewed by 1348

Abstract

Studies have demonstrated that polymorphic variants of arginase 1 gene (ARG1) are involved in human diseases, such as coronary heart disease, hypertension, and diabetes. Our study aimed to investigate the association between ARG1 rs2781666 single nucleotide polymorphism (SNP) and diabetic retinopathy (DR) in type 2 diabetes (T2DM) patients. Polymorphism was genotyped in 740 T2DM patients and 400 healthy individuals. A significant difference in the genotype distribution was observed between the patients and the controls. The T allele and TT genotype were associated with an increased risk of T2DM (OR 1.4, 95% CI 1.14–1.72, p = 0.001 and OR 2.16, 95% CI 1.23–3.80, p = 0.007, respectively). When the T2DM subjects were stratified into DR+ and DR− subgroups, the T allele and TT genotype frequencies were significantly higher in the DR+ group compared to the DR− group, demonstrating OR 1.68 (1.33–2.12), p < 0.0001 and OR 2.39 (1.36–4.18), p = 0.002, respectively. Logistic regression analysis was applied to determine the interaction between the ARG1 genotypes and other risk factors. Only ARG1 rs2781666 SNP was a significant risk predictor of DR (p = 0.003). In conclusion, this is the first report discussing the effect of ARG1 polymorphism on the microvascular complications that are associated with diabetes. Our findings demonstrate that ARG1 rs2781666 SNP is significantly associated with an increased susceptibility to DR in T2DM patients. Full article

(This article belongs to the Special Issue Molecular Insights and Treatment of Diabetic Retinopathy)

14 pages, 401 KiB

Open AccessArticle

The Role of Hemoglobin A1C in Diabetes Screening and Diabetic Retinopathy

by Maria Mercedes Chang Villacreses, Rudruidee Karnchanasorn, Horng-Yih Ou, Raynald Samoa, Lee-Ming Chuang and Ken C. Chiu

J. Clin. Med. 2021, 10(21), 4947; https://doi.org/10.3390/jcm10214947 - 26 Oct 2021

Viewed by 2365

Abstract

Hemoglobin A1C (A1C) is used in various settings. Its performance has not been evaluated systemically. We compared A1C in diagnosis of diabetes with fasting plasma glucose (FPG) and 2-h postchallenged plasma glucose (2hPG) parameters in a cross-sectional cohort in the United Stated. Adult subjects (≥20 years) were identified from the National Health and Nutrition Examination Survey 2005–2016 without a history of diabetes who had BMI, A1C, FPG, and 2hPG (n = 10,416). For comparisons, we calculated the sample weighted prevalence, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) with subgroup analyses. For the retinopathy study, diabetic subjects with established diabetes who responded to the question of diabetic retinopathy were evaluated (n = 3907). Compared to the FPG/2hPG criteria, A1C ≥ 48 mmol/mol (6.5%) had a low sensitivity at 25.90%, with specificity 99.70%, PPV 84.70%, and NPV 95.70%. Subgroup analyses revealed a lower sensitivity in males (24.52%); the lowest in non-Hispanic White (21.35%), in the third decade (14.32%), and in the BMI < 22.50 kg/m² group (7.21%). The prevalence of self-reported diabetic retinopathy increased drastically with an inflection point at A1C 48 mmol/mol (6.5%) from 11.52% to 18.32% (p < 0.0001). A1C ≥ 48 mmol/mol (6.5%) should be cautiously used to diagnose diabetes in certain subgroups due to very low sensitivity in certain groups. With the confirmation of the association of increasing self-reported diabetic retinopathy with A1C ≥ 48 mmol/mol (6.5%), the current A1C cutoff is an acceptable value with the understanding of especially low sensitivity in certain subgroups. Full article

(This article belongs to the Special Issue Molecular Insights and Treatment of Diabetic Retinopathy)

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10 pages, 1253 KiB

Open AccessArticle

Effect of Intravitreal Bevacizumab Injection before Panretinal Photocoagulation on the Prevention of Macular Edema Aggravation in Proliferative Diabetic Retinopathy

by Wungrak Choi, Hyun Goo Kang, Eun Young Choi, Sung Soo Kim, Hyoung Jun Koh and Min Kim

J. Clin. Med. 2020, 9(11), 3772; https://doi.org/10.3390/jcm9113772 - 23 Nov 2020

Cited by 2 | Viewed by 1738

Abstract

Objective: To investigate the effects of intravitreal bevacizumab (IVB) injection before PRP on the prevention of macular edema (ME) in patients with PDR. Methods: This retrospective observational study included patients diagnosed with PDR treated by PRP with (combination group) or without (PRP alone group) preoperative IVB injection (1.25 mg/0.05 mL). The primary outcome measure was the change in the central macular thickness (CMT), while the secondary outcome measure was the change in visual acuity. Measurements were made before and at one, two, and three months after treatment. Results: In the PRP alone group, the mean baseline CMT of 277.8 μm increased to 290.4 μm at one month (p = 0.201) and 308.8 μm at two months (p = 0.002), followed by a decrease to 271.2 μm at three months (p = 0.437). In the combination group, the values at baseline and one, two, and three months after PRP were 322.9 μm, 295.4 μm (p = 0.002), 330.1 μm (p = 0.906), and 274.5 μm (p = 0.030), respectively. Visual acuity changes were comparable between the two groups at all time points. Conclusion: IVB injection before PRP leads to decreased CMT in comparison to CMT in patients with PRP alone. Full article

(This article belongs to the Special Issue Molecular Insights and Treatment of Diabetic Retinopathy)

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12 pages, 6173 KiB

Open AccessArticle

Comparison of 2-Year Outcomes between Intravitreal Ranibizumab and Intravitreal Aflibercept for Diabetic Macular Edema with “Treat-and-Extend” Regimen—Its Usefulness and Problems

by Shinichiro Chujo, Masahiko Sugimoto, Taku Sasaki, Yoshitsugu Matsui, Kumiko Kato, Atsushi Ichio, Ryohei Miyata, Hisashi Matsubara and Mineo Kondo

J. Clin. Med. 2020, 9(9), 2848; https://doi.org/10.3390/jcm9092848 - 2 Sep 2020

Cited by 9 | Viewed by 3023

Abstract

Background: To compare the effectiveness of intravitreal ranibizumab (IVR) and intravitreal aflibercept (IVA) performed with the treat-and-extend (TAE) regimen on eyes with diabetic macular edema (DME). Patients and methods: This is a retrospective study of 125 eyes of 125 treatment-naïve DME patients who received anti-VEGF injections at three consecutive monthly intervals as the loading phase. The changes in the best-corrected visual acuity (BCVA), central retinal thickness (CRT), diabetic retinopathy severity scale (DRSS), and total injection numbers were compared between the two anti-VEGF agents. Results: Among 125 eyes, 26 eyes completed the treatment with the TAE regimen for 24 months (20.8%). Thirteen eyes of 13 patients (mean age, 70.9 ± 6.0 years) received intravitreal injections of 0.5 mg ranibizumab, and 13 eyes of 13 patients (65.9 ± 8.6 years) received 2 mg aflibercept. No significant differences were detected in the baseline demographics. At 24 months, BCVA was significantly improved in both groups; from 0.31 ± 0.19 to 0.10 ± 0.12 logMAR units for IVR and 0.41 ± 0.19 to 0.16 ± 0.28 logMAR units for IVA (p = 1.29 × 10⁻⁹). CRT was significantly reduced in both groups; 440.9 ± 69.3 to 307.5 ± 66.4 μm for IVR and 473.9 ± 71.5 to 317.8 ± 71.2 μm for IVA (p = 3.55 × 10⁻⁹). No significant differences were detected in the improvements of BCVA, CRT in both groups, and the total injection numbers for 24 months (11.0 ± 1.2 for the IVA group and 12.0 ± 1.0 the IVR group). DRSS was significantly improved in both groups (p = 0.0004 for IVR and p = 0.009 for IVA). Conclusion: No significant differences were detected in the improvements of BCVA or CRT and injection numbers between the IVR and IVA groups treated with the TAE regimen. These results indicate that the results of the treatment with both agents with the TAE regimen were equally effective, but only 20.8% of patients completed 24 months of continuous treatment with the TAE regimen. Synopsis: There are no significant differences regarding effectiveness between the IVR and IVA groups treated with the TAE regimen for DME eyes. Full article

(This article belongs to the Special Issue Molecular Insights and Treatment of Diabetic Retinopathy)

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