The Diagnosis and Treatment of Early Stage Diabetic Retinopathy

Abstract

Diabetic retinopathy (DR) is the leading cause of blindness in adults 20 to 74 years of age. Detecting early stage retinopathy prior to the onset of clinical findings would greatly impact the management and treatment of DR. We have identified several tests that show dysfunction in the retina prior to the onset of clinically‐significant vascular lesions induced by diabetes. We have determine that rod photoreceptor function is most vulnerable to diabetes using novel stimuli with the electroretinogram. Our studies show similar delays in rodent models of diabetes and diabetic patients, prior to clinically diagnosed DR. In addition, we have shown that spatial frequency and contrast sensitivity declines prior to vascular changes when tested with moving gratings. Finally, we have demonstrated that the application of inducible fluorescent tags to detect ROS in the retina, providing another possible screening tool for DR. To determine the mechanisms underlying neuronal dysfunction in early DR, we examined the role of decreased retinal dopamine, a key neuromodulator in the retina. Using our screening tools to detect early disease, we are able to preserve retinal and visual function in diabetic rodents by restoring dopamine levels with L‐DOPA or exercise therapies.