Diabetic Retinopathy, Oxidative Stress and Antioxidants

摘要

Diabetic retinopathy is the leading cause of blindness in young adults. The mechanisms that lead to its development are poorly understood. Studies have shoutn that the maintenance of good metabolic control is the best treatment to prevent/inhibit the development of diabetic retinopathy, but such control is often difficult to maintain for long duration. Oxidative stress and nitrosylation of retinal proteins are increased in diabetes, and the retinal mitochondria become dysfunctional. Dietary supplementation with antioxidants in animal models of diabetic retinopathy is beneficial in inhibiting the accelerated retinal capillary cell apoptosis, development of retinopathy and the metabolic abnormalities that are postulated to be involved in the pathogenesis of diabetic retinopathy. However, clinical data with antioxidants in diabetic patients is somewhat ambiguous. Since diabetic retinopathy is a multifactorial disease, a single antioxidant or a group of drugs may not entirely prevent or inhibit diabetic retinopathy. However, it is likely that supplementation with multi-antioxidants with different mechanisms of actions could provide an inexpensive adjunct therapy to help preserve vision in diabetic patients. This could offer patients an opportunity to supplement their best possible sensible glycemic control with additional therapies.