Abstract

A REVIEW ON PATHOPHYSIOLOGY AND TREATMENT OF DIABETIC RETINOPATHY

Prabhu Dayal Rajan*, Lalit Parihar, Dr. Sanjar Alam, Dr. Pradeep Kr Sharma, Rashid Khan and Shekhar Prakash Kushwaha

ABSTRACT

Diabetes is now regarded as an epidemic, The risk of development and progression of diabetic retinopathy (DR) is closely associated with the type and duration of diabetes, blood glucose, blood pressure, and possibly lipids. The aim of this paper is to understand the pathophysiology and treatment options for diabetic retinopathy. Pathophysiology include biochemical pathway acts as key contributors in the development of DR, namely, increased polyol pathway, activation of protein kinase C (PKC), increased expression of growth factors such as vascular endothelial growth factor (VEGF) and insulin-like growth factor-1(IGF1), haemodynamic changes, accelerated formation of advanced glycation endproducts (AGEs), oxidative stress, activation of the renin angiotensin aldosterone system (RAAS) and capillary occlusion. Treatment include inhibitors of these biochemical pathway, mainly DR is of two types non proliferative DR(NPDR) and proliferative DR(PDR),In NPDR, tight glucose control,blood pressure management, fluorescein angiography, laser therapy used and for PDR, panretinal photocoagulation, reduce ischemia, vitrectomy are used. DR can also be treat by using ayurvedic drugs at early stage like neem, kerala, jamun, gynura, tulsi, kaddi patta, fennel, guava, cumine, black pepper, ginseng and sadabahar.

Keywords: Diabetic retinopathy, pathophysiology, fluorescein angiography, vitrectomy, oxidative stress.