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Diabetic retinopathy barrier

Aditi Gupta, Jerry Cavallerano, Jennifer K Sun, Paolo S Silva
According to current projections, the number of Americans with diabetes mellitus will increase from 27.8 million in 2007 to 60.7 million in 2030. With the increasing gap between demand for eye care and supply of ophthalmologists and optometrists, and the non-uniform distribution of eye care providers in US counties, barriers to eye examinations will likely increase. Telemedicine assessment of diabetic retinal disease through remote retinal imaging and diagnosis has the potential to meet these growing demands...
October 17, 2016: Seminars in Ophthalmology
Yang Lu, Lilian Serpas, Pauline Genter, Betty Anderson, David Campa, Eli Ipp
INTRODUCTION: Despite availability of screening for diabetic retinopathy, testing is underused by many low-income and racial/ethnic minority patients with diabetes. We examined perceived barriers to diabetic retinopathy screening among low-income patients and their health care providers and provider staffers. METHODS: We collected survey data from 101 patients with diabetes and 44 providers and staffers at a safety-net clinic where annual diabetic retinopathy screening rates were low...
October 6, 2016: Preventing Chronic Disease
Nadine Reichhart, Sergio Crespo-Garcia, Nadine Haase, Michaela Golic, Sergej Skosyrski, Anne Rübsam, Christina Herrspiegel, Norbert Kociok, Natalia Alenina, Michael Bader, Ralf Dechend, Olaf Strauss, Antonia M Joussen
AIMS/HYPOTHESIS: Although the renin-angiotensin system plays an important role in the progression of diabetic retinopathy, its influence therein has not been systematically evaluated. Here we test the suitability of a new translational model of diabetic retinopathy, the TetO rat, for addressing the role of angiotensin-II receptor 1 (AT1) blockade in experimental diabetic retinopathy. METHODS: Diabetes was induced by tetracycline-inducible small hairpin RNA (shRNA) knockdown of the insulin receptor in rats, generating TetO rats...
October 4, 2016: Diabetologia
Undurti N Das
Diabetic macular edema (DME) and diabetic retinopathy (DR) are complications affecting about 25% of all patients with long-standing type 1 and type 2 diabetes mellitus and are a major cause of significant decrease in vision and quality of life. Age-related macular degeneration (AMD) is not uncommon, and diabetes mellitus affects the incidence and progression of AMD through altering hemodynamics, increasing oxidative stress, accumulating advanced glycation end products, etc. Recent studies suggest that DME, DR and AMD are inflammatory conditions characterized by a breakdown of the blood-retinal barrier, inflammatory processes and an increase in vascular permeability...
October 1, 2016: Archives of Medical Science: AMS
Nancy M Holekamp
Diabetic retinopathy (DR) is both the leading cause of blindness among adults aged 20 to 74 in the United States, and the leading ocular complication associated with diabetes mellitus (DM). An estimated 4.4% of adults with DM over 40 years of age have the more advanced form of DR: diabetic macular edema (DME), which significantly increases the risk of blindness. Medical costs for Medicare patients with DME are a third higher than for patients without DME. The majority of these costs stem from other DM-related complications, as DME is a marker for poorly controlled DM overall...
July 2016: American Journal of Managed Care
Zachary Keenum, Gerald McGwin, C Douglas Witherspoon, Julia A Haller, Mark E Clark, Cynthia Owsley
Importance: The public health success of diabetic retinopathy (DR) screening programs depends on patients' adherence to the timetable of follow-up eye care recommended by the screening program. African Americans are among those at highest risk for DR and have one of the lowest rates of eye care use. Objectives: To assess the rate of adhering to recommended follow-up eye care in a DR screening program administered in a safety-net health care facility and to examine factors associated with follow-up eye care use...
September 15, 2016: JAMA Ophthalmology
Lutz Heinemann, Diana Drossel, Guido Freckmann, Bernhard Kulzer
The estimation is that every third to fourth patient with diabetes suffers from some degree of diabetic retinopathy. Medical products for insulin administration (such as insulin pens and pumps) or glucose monitoring not optimized to the needs of these patients' represent a high barrier for optimal diabetes therapy in daily practice. To date, the number of devices suitable for visually impaired and blind patients with diabetes is scarce. This manuscript outlines the specific needs of this patient group with regard to systems for insulin administration, blood glucose measurement, and continuous glucose monitoring...
September 6, 2016: Journal of Diabetes Science and Technology
Pablo F Barcelona, Nicholas Sitaras, Alba Galan, Gema Esquiva, Sean Jmaeff, Yifan Jian, Marinko V Sarunic, Nicolas Cuenca, Przemyslaw Sapieha, H Uri Saragovi
UNLABELLED: In many diseases, expression and ligand-dependent activity of the p75(NTR) receptor can promote pericyte and vascular dysfunction, inflammation, glial activation, and neurodegeneration. Diabetic retinopathy (DR) is characterized by all of these pathological events. However, the mechanisms by which p75(NTR) may be implicated at each stage of DR pathology remain poorly understood. Using a streptozotocin mouse model of diabetic retinopathy, we report that p75(NTR) is upregulated very early in glia and in pericytes to mediate ligand-dependent induction of inflammatory cytokines, disruption of the neuro-glia-vascular unit, promotion of blood-retina barrier breakdown, edema, and neuronal death...
August 24, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Elena Beltramo, Tatiana Lopatina, Aurora Mazzeo, Ana I Arroba, Angela M Valverde, Cristina Hernández, Rafael Simó, Massimo Porta
AIMS: Diabetic retinopathy is considered a microvascular disease, but recent evidence has underlined early involvement of the neuroretina with interactions between microvascular and neural alterations. Topical administration of somatostatin (SST), a neuroprotective molecule with antiangiogenic properties, prevents diabetes-induced retinal neurodegeneration in animals. The α2-adrenergic receptor agonist brimonidine (BRM) decreases vitreoretinal vascular endothelial growth factor and inhibits blood-retinal barrier breakdown in diabetic rats...
August 23, 2016: Acta Diabetologica
António Campos, Elisa J Campos, João Martins, António Francisco Ambrósio, Rufino Silva
Diabetic macular oedema (DMO) is the leading cause of vision loss in the working-age population. Blood-retinal barrier (BRB) dysfunction in diabetic retinopathy (DR), mainly at the level of the retinal vessels, has long been related with leakage and fluid accumulation, leading to macular oedema. However, the nourishment of the macula is provided by the choroid and a diabetic choroidopathy has been described. Therefore, there has been a growing interest in studying the role of the choroid in the pathophysiology of DR and DMO, mainly by optical coherence tomography (OCT)...
August 22, 2016: Acta Ophthalmologica
Ella Graham-Rowe, Fabiana Lorencatto, John G Lawrenson, Jennifer Burr, Jeremy M Grimshaw, Noah M Ivers, Tunde Peto, Catey Bunce, Jill J Francis
BACKGROUND: Diabetic retinopathy is a serious complication of diabetes which, if left untreated, can result in blindness. Population screening among people with diabetes has been shown to be clinically effective; however, suboptimal attendance with wide demographic disparities has been reported. To develop quality improvement interventions to maximise attendance, it is important to understand the theoretical determinants (i.e. barriers and enablers) of screening behaviour. The aim of this systematic review is to identify and synthesise the modifiable barriers and enablers associated with diabetic retinopathy screening attendance...
2016: Systematic Reviews
Eric L Goldwaser, Nimish K Acharya, Abhirup Sarkar, George Godsey, Robert G Nagele
Alzheimer's disease (AD) and diabetes mellitus (DM) are among the most pervasive and devastating disorders that afflict people throughout the world. Although typically associated with older demographics, recent epidemiologic studies have reported parallel trends in decreasing age of onset and increasing incidence of these conditions. Promising research continues to implicate the cerebrovasculature and blood-brain barrier (BBB) as playing key roles in AD pathoetiology. Similarly, complications accompanying DM, such as diabetic nephropathy/retinopathy, cardiovascular disease, and stroke, have been rooted in vascular compromise...
September 6, 2016: Journal of Alzheimer's Disease: JAD
Ahamed Hossain, Lamiya Tauhid, Ian Davenport, Thomas Huckaba, Richard Graves, Tarun Mandal, Syed Muniruzzaman, Syed A Ahmed, Partha S Bhattacharjee
PURPOSE: The cell surface LDL (low-density lipoprotein) receptor-related protein-1 (LRP-1) is important for lipid transport and several cell signaling processes. Human apolipoprotein E (apoE) is a ligand of LRP-1. We previously reported that a short peptide (apoEdp) mimicking the LRP-1 binding region of apoE prevents hyperglycemia-induced retinal endothelial cell dysfunction in vitro. The in-vivo outcome of apoE-based peptidomimetic inhibition of LRP-1 in the treatment of diabetic retinopathy is unknown...
July 21, 2016: Current Eye Research
Mitra Farnoodian, Caroline Halbach, Cassidy Slinger, Bikash R Pattnaik, Christine M Sorenson, Nader Sheibani
Defects in the outer blood-retinal barrier have significant impact on the pathogenesis of diabetic retinopathy and macular edema. However, the detailed mechanisms involved remain largely unknown. This is, in part, attributed to the lack of suitable animal and cell culture models, including those of mouse origin. We recently reported a method for the culture of retinal pigment epithelial (RPE) cells from wild-type and transgenic mice. The RPE cells are responsible for maintaining the integrity of the outer blood-retinal barrier whose dysfunction during diabetes has a significant impact on vision...
September 1, 2016: American Journal of Physiology. Cell Physiology
Khalil Miloudi, François Binet, Ariel Wilson, Agustin Cerani, Malika Oubaha, Catherine Menard, Sullivan Henriques, Gaelle Mawambo, Agnieszka Dejda, Phuong Trang Nguyen, Flavio A Rezende, Steve Bourgault, Timothy E Kennedy, Przemyslaw Sapieha
Diabetic retinopathy (DR) is a major complication of diabetes and a leading cause of blindness in the working-age population. Impaired blood-retinal barrier function leads to macular edema that is closely associated with the deterioration of central vision. We previously demonstrated that the neuronal guidance cue netrin-1 activates a program of reparative angiogenesis in microglia within the ischemic retina. Here, we provide evidence in both vitreous humor of diabetic patients and in retina of a murine model of diabetes that netrin-1 is metabolized into a bioactive fragment corresponding to domains VI and V of the full-length molecule...
August 1, 2016: Journal of Clinical Investigation
Jung Mo Kim, Ki-Sung Hong, Won Kyung Song, Daekyeong Bae, In-Kyu Hwang, Jong Soo Kim, Hyung-Min Chung
UNLABELLED: : Diabetic retinopathy (DR) is the leading cause of blindness in working-age people. Pericyte loss is one of the pathologic cellular events in DR, which weakens the retinal microvessels. Damage to the microvascular networks is irreversible and permanent; thus further progression of DR is inevitable. In this study, we hypothesize that multipotent perivascular progenitor cells derived from human embryonic stem cells (hESC-PVPCs) improve the damaged retinal vasculature in the streptozotocin-induced diabetic rodent models...
September 2016: Stem Cells Translational Medicine
Mudit Tyagi, Vikas Ambiya, Padmaja Kumari Rani
We report the case of a 58-year-old man with proliferative diabetic retinopathy in both eyes, and a history of recurrent anterior uveitis in the right eye, who underwent panretinal laser photocoagulation (PRP) for the retinopathy in both eyes, following which he developed hypopyon uveitis in the right eye. The condition was managed with topical steroids and cycloplegics, to which he readily responded. The case highlights that there is a breakdown of the blood aqueous barrier consequent to PRP. Patients with a history of uveitis are predisposed to develop recurrent uveitis after the said procedure and should be closely watched for such complications...
2016: BMJ Case Reports
Éva Csősz, Eszter Deák, Gergő Kalló, Adrienne Csutak, József Tőzsér
: Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness among patients with diabetes. The appearance and the severity of the symptoms correlate with the duration of diabetes and poor blood glucose level management. Diabetic retinopathy is also categorized as a chronic low-level inflammatory disease; the high blood glucose level promotes the accumulation of the advanced glycation end products and leads to the stimulation of monocytes and macrophages...
June 30, 2016: Journal of Proteomics
Ahamed Hossain, David Heron, Ian Davenport, Thomas Huckaba, Richard Graves, Tarun Mandal, Syed Muniruzzaman, Shusheng Wang, Partha S Bhattacharjee
CD13/APN (aminopeptidase N) was first identified as a selective angiogenic marker expressed in tumor vasculature and is considered a target for anti-cancer therapy. CD13 was also reported to express in non-diabetic, hypoxia-induced retinal neovascularization. Whether diabetes induces upregulation of CD13 expression in the retina is unknown. We hypothesize that at an early stage of non-proliferative diabetic retinopathy (NPDR) characterized by disruption of blood-retinal barrier (BRB) permeability is related to upregulated expression of CD13 because of its known role in extracellular matrix (ECM) degradation...
August 2016: Experimental Eye Research
Jeremy Y Yu, Mei Du, Michael H Elliott, Mingyuan Wu, Dongxu Fu, Shihe Yang, Arpita Basu, Xiaowu Gu, Jian-Xing Ma, Christopher E Aston, Timothy J Lyons
AIMS/HYPOTHESIS: We aimed to determine whether plasma lipoproteins, after leakage into the retina and modification by glycation and oxidation, contribute to the development of diabetic retinopathy in a mouse model of type 1 diabetes. METHODS: To simulate permeation of plasma lipoproteins into retinal tissues, streptozotocin-induced mouse models of diabetes and non-diabetic mice were challenged with intravitreal injection of human 'highly-oxidised glycated' low-density lipoprotein (HOG-LDL), native- (N-) LDL, or the vehicle PBS...
September 2016: Diabetologia
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