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Review
. 2007:2007:43603.
doi: 10.1155/2007/43603.

Oxidative stress and diabetic retinopathy

Renu A Kowluru  1 , Pooi-See Chan
Affiliations
Review

Oxidative stress and diabetic retinopathy

Renu A Kowluru et al. Exp Diabetes Res. 2007.

Abstract

Oxygen metabolism is essential for sustaining aerobic life, and normal cellular homeostasis works on a fine balance between the formation and elimination of reactive oxygen species (ROS). Oxidative stress, a cytopathic consequence of excessive production of ROS and the suppression of ROS removal by antioxidant defense system, is implicated in the development of many diseases, including Alzheimer's disease, and diabetes and its complications. Retinopathy, a debilitating microvascular complication of diabetes, is the leading cause of acquired blindness in developed countries. Many diabetes-induced metabolic abnormalities are implicated in its development, and appear to be influenced by elevated oxidative stress; however the exact mechanism of its development remains elusive. Increased superoxide concentration is considered as a causal link between elevated glucose and the other metabolic abnormalities important in the pathogenesis of diabetic complications. Animal studies have shown that antioxidants have beneficial effects on the development of retinopathy, but the results from very limited clinical trials are somewhat ambiguous. Although antioxidants are being used for other chronic diseases, controlled clinical trials are warranted to investigate potential beneficial effects of antioxidants in the development of retinopathy in diabetic patients.

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Figures

Figure 1
Figure 1
Glucose damages the retina via repeated acute and/or cumulative changes. Continued high circulating glucose in diabetes can damage retina via many acute and cumulative long-term changes that can cause tissue injury. Some acute insult, when repeated multiple times in this life-long disease, can result in cumulative changes in stable macromolecules.
Figure 2
Figure 2
Oxidative stress-mediated dysmetabolisms in diabetic retinopathy. Oxidative stress is a cytopathic consequence of excessive production of reactive oxygen species (ROS) and the suppression of ROS removal by antioxidant defense system. Hyperglycemia-induced oxidative stress is considered a causal link between elevated glucose and other metabolic abnormalities important in the development of diabetic complications. Several diabetes-induced abnormalities in the retina that are postulated in the development of retinopathy are influenced by oxidative stress, and are considered to be interrelated.
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