Perturbed Biochemical Pathways and Associated Oxidative Stress Lead to Vascular Dysfunctions in Diabetic Retinopathy

Abstract EN

Diabetic retinopathy (DR) is a vascular insult that accompanies the hyperglycemic state.

Retinal vasculature holds a pivotal role in maintaining the integrity of the retina, and any alteration to retinal vasculature affects retinal functions.

The blood retinal barrier, a prerequisite to vision acuity, is most susceptible to damage during the progression of DR.

This is a consequence of impaired biochemical pathways such as the polyol, advanced end glycation products (AGE), hexosamine, protein kinase C (PKC), and tissue renin-angiotensin system (RAS) pathways.

Moreover, the role of histone modification and altered miRNA expression is also emerging as a major contributor.

Epigenetic changes create a link between altered protein function and redox status of retinal cells, creating a state of metabolic memory.

Although various biochemical pathways underlie the etiology of DR, the major insult to the retina is due to oxidative stress, a unifying factor of altered biochemical pathways.

This review primarily focuses on the critical biochemical pathways altered in DR leading to vascular dysfunctions and discusses antioxidants as plausible treatment strategies.