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Current Challenges and Advances in Diabetic Retinopathy

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 4719

Special Issue Editor


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Guest Editor
Centre of Ophthalmology, Eberhard Karls University Tübingen, Elfriede-Aulhorn-Straße 7, 72076 Tübingen, Germany
Interests: diabetic eye disease; adherence; pharmacovigilance; metabolomic; retinal imaging; artificial intelligence

Special Issue Information

Dear Colleagues,

The area of diabetes eye disease is on the move. Important insights have been gained in recent years concerning the pathophysiology, risk-dependent early detection and therapeutic strategies of diabetic retinopathy.

There is still great potential to improve interdisciplinary cooperation and research. Retinopathy is indeed mentioned as an important microvascular complication, but the methodical recording of clinical endpoints and objective documentation within large diabetological trials is still in its infancy. The strong specialisation of ophthalmology may contribute to the fact that some natural scientists, internists and endocrinologists shy away from cooperation between different specialist groups.

The present Special Issue should encourage the presentation of new concepts and steps towards a better understanding and clinical care:

  • There is great interest and need to overcome the limitations of old rodent experiments ‘generation streptozotocin’ and to gain clinical insights into diabetes drugs and influencing factors by new models;
  • Important technical developments make it possible to map the pathophysiological significance of inflammation, neurodegeneration and hypoxia/vasculopathy and to integrate them into new classifications. Among the numerous innovations are optical coherence tomography (structural and angiographic/OCT-A), automatic image and vessel analysis via neural networks, analysis of large data and ultrawide-angle imaging;
  • Risk stratification and telemedicine are frequently used buzzwords. What is needed, however, is a content-related examination of the concrete implementation in everyday life. The agreement of patient autonomy and data protection, the integration of fundus photography into other ophthalmic care, the preservation of a speaking medicine and the development of new ways of patient education and motivation should be in the focus;
  • After the remarkable success of anti-VEGF therapy, the question of alternative or supporting treatment strategies arises.

The present Special Issue is intended to take up technical innovations, the digital revolution, molecular–biological screws and the detection/therapy of retinopathy in order to lead scientists from different disciplines to a dialogue. You are kindly requested to address one of the most relevant problems of the major widespread diseases. The number one concern of people with diabetes is loss of sight. In summary, all manuscripts with an impact on the development of new diagnostic or therapeutic approaches and clinical care of diabetic retinopathy are highly welcome.

Prof. Dr. Focke Ziemssen
Guest Editor

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Keywords

  • preclinical models of diabetic retinopathy
  • teleophthalmology
  • patient utilisation
  • neuronal networks/artificial intelligence
  • diabetic macular edema
  • treatment strategies
  • motivation work
  • digital tools
  • risk factors
  • retinal imaging

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Published Papers (1 paper)

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Review

12 pages, 428 KiB  
Review
Diabetic Retinopathy: Mitochondria Caught in a Muddle of Homocysteine
by Renu A. Kowluru
J. Clin. Med. 2020, 9(9), 3019; https://doi.org/10.3390/jcm9093019 - 19 Sep 2020
Cited by 16 | Viewed by 3592
Abstract
Diabetic retinopathy is one of the most feared complications of diabetes. In addition to the severity of hyperglycemia, systemic factors also play an important role in its development. Another risk factor in the development of diabetic retinopathy is elevated levels of homocysteine, a [...] Read more.
Diabetic retinopathy is one of the most feared complications of diabetes. In addition to the severity of hyperglycemia, systemic factors also play an important role in its development. Another risk factor in the development of diabetic retinopathy is elevated levels of homocysteine, a non-protein amino acid, and hyperglycemia and homocysteine are shown to produce synergistic detrimental effects on the vasculature. Hyperhomocysteinemia is associated with increased oxidative stress, and in the pathogenesis of diabetic retinopathy, oxidative stress-mitochondrial dysfunction precedes the development of histopathology characteristic of diabetic retinopathy. Furthermore, homocysteine biosynthesis from methionine forms S-adenosyl methionine (SAM), and SAM is a co-substrate of DNA methylation. In diabetes, DNA methylation machinery is activated, and mitochondrial DNA (mtDNA) and several genes associated with mitochondrial homeostasis undergo epigenetic modifications. Consequently, high homocysteine, by further affecting methylation of mtDNA and that of genes associated with mtDNA damage and biogenesis, does not give any break to the already damaged mitochondria, and the vicious cycle of free radicals continues. Thus, supplementation of sensible glycemic control with therapies targeting hyperhomocysteinemia could be valuable for diabetic patients to prevent/slow down the development of this sight-threatening disease. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Diabetic Retinopathy)
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