RETINA CHANGES IN DIABETES: MORPHOLOGICAL, MICROANGIOPATHIC AND MOLECULAR MECHANISMS AND BIOCHEMICAL SIGNIFICANCE OF USED DRUGS
Keywords:
diabetes; diabetic retinopathy; retina; microangiopathy; pericytes; capillary basement membrane; oxidative stress; advanced glycation end products (AGE); protein kinase C (PKC); VEGF; neovascularization; diabetic macular edema; anti-VEGF drugs; microcirculation.Abstract
Diabetes mellitus (DM) is a chronic metabolic disease , one of the most severe and clinically significant complications of which is diabetic retinopathy. This article comprehensively analyzes the morphological, microangiopathic and molecular changes that occur in the retina of the eye in diabetes. The role of thickening of the basement membrane of retinal capillaries, selective loss of pericytes, endothelial dysfunction, capillary occlusion, ischemia and hypoxia in the pathogenesis is highlighted. Also, the mechanisms of pathological neovascularization caused by oxidative stress, glucose polyol pathway, advanced glycation end products (AGE), protein kinase C (PKC) activation, and VEGF were scientifically described. The article analyzes the biochemical mechanisms of action of anti-VEGF drugs, corticosteroids, antioxidant and angioprotective drugs used in the treatment of diabetic retinopathy, and shows their importance in improving retinal microcirculation and slowing disease progression. The obtained data serve as a scientific basis for early diagnosis of diabetic retinopathy, pathogenesis-oriented therapy , and improvement of preventive approaches.
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