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Cited by 468Retinal Diseases and TreatmentsRetinal Imaging and AnalysisDiabetes Management and Research

Diabetic retinopathy as the leading cause of blindness and early predictor of cascading complications—risks and mitigation

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Kropp, Martina, Golubnitschaja, Olga, Mazurakova, Alena, Koklesova, Lenka, Sargheini, Nafiseh, Vo, Trong-Tin Kevin Steve, de Clerck, Eline, Polivka, Jiri +5 more·2023·EPMA Journal
DOI 10.1007/s13167-023-00314-8PMC PMC9971534
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Abstract

Proliferative diabetic retinopathy (PDR) the sequel of diabetic retinopathy (DR), a frequent complication of diabetes mellitus (DM), is the leading cause of blindness in the working-age population. The current screening process for the DR risk is not sufficiently effective such that often the disease is undetected until irreversible damage occurs. Diabetes-associated small vessel disease and neuroretinal changes create a vicious cycle resulting in the conversion of DR into PDR with characteristic ocular attributes including excessive mitochondrial and retinal cell damage, chronic inflammation, neovascularisation, and reduced visual field. PDR is considered an independent predictor of other severe diabetic complications such as ischemic stroke. A “domino effect” is highly characteristic for the cascading DM complications in which DR is an early indicator of impaired molecular and visual signaling. Mitochondrial health control is clinically relevant in DR management, and multi-omic tear fluid analysis can be instrumental for DR prognosis and PDR prediction. Altered metabolic pathways and bioenergetics, microvascular deficits and small vessel disease, chronic inflammation, and excessive tissue remodelling are in focus of this article as evidence-based targets for a predictive approach to develop diagnosis and treatment algorithms tailored to the individual for a cost-effective early prevention by implementing the paradigm shift from reactive medicine to predictive, preventive, and personalized medicine (PPPM) in primary and secondary DR care management.

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Cited by

Sorted by citations

Authors
Kropp, M., Golubnitschaja, O., Mazurakova, A., Koklesova, L., Sargheini, N., Vo, T.-T. K. S., de Clerck, E., Polivka, J., Potuznik, P., Polivka, J., Stetkarova, I., Kubatka, P., & Thumann, G.
Affiliations
  • University of Geneva (CH)
  • University of Bonn (DE)
  • Max Planck Institute for Plant Breeding Research (DE)
  • Comenius University Bratislava (SK)
Corresponding author
  • Kropp, Martina
  • Golubnitschaja, Olga
ORCID
Venue
EPMA Journal
Publisher
Springer Science and Business Media LLC
Published
2023-02-13
Volume
14
Issue
1
Pages
21-42
ISSN
  • 1878-5077 (ISSN-L)
  • 1878-5085
DOI
10.1007/s13167-023-00314-8
PMC
PMC9971534
OpenAlex
W4320481312
Cited by
468
References
5
Citations by year
2026: 148 · 2025: 165 · 2024: 122 · 2023: 33
FWCI
23.87
Type
journal article
Language
en
Open access
Licence
Locations
  • The EPMA Journal (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
Funders
Rheinische Friedrich-Wilhelms-Universität Bonn
Topics
  • Health Sciences › Medicine › Ophthalmology › Retinal Diseases and Treatments
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Retinal Imaging and Analysis
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Management and Research
Keywords
diabetic retinopathy, proliferative diabetic retinopathy, blindness, diabetes complications, mitochondrial damage, chronic inflammation, neovascularization, ischemic stroke, predictive medicine, personalized medicine, early detection

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