How to Improve Detection and Treatment of Diabetic Retinopathy

Abstract

Diabetic retinopathy (DR) is the leading cause of blindness in working age adults. DR is clinically diagnosed by late stage vascular changes in the retina. Detecting early stage retinopathy prior to the onset of these 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 vascular lesions induced by diabetes. Using novel stimuli with the electroretinogram, we have determined that rod photoreceptor function is most vulnerable to diabetes. Our studies show similar delays in rodent models of diabetes and diabetic patients, prior to clinically diagnosed DR, suggesting a potential screening tool. In addition, we have shown that spatial frequency and contrast sensitivity thresholds decline prior to vascular changes when tested with moving gratings. Finally, we have demonstrated the application of reactive fluorescent tags to detect reactive oxygen species in the retina, providing another possible screening tool for DR. The detection of early stage DR opens a therapeutic window for neuroprotective agents that could slow or halt the progression of disease. We have demonstrated that L-DOPA or exercise treatments are promising interventions to slow the progression of DR and preserve visual function.