Pathologic Alterations of the Outer Retina in Streptozotocin-Induced Diabetes

Énzsöly, Anna; Szabó, Arnold; Kántor, Orsolya; Chiu, David; Szalay, Péter G.; Szabó, Klaudia; Szél, Ágoston; Németh, János; Lukáts, Ákos

doi:10.1167/iovs.13-13562

Cited by 64 publications

(90 citation statements)

References 55 publications

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“…Thus, it is more likely that the cones are present but are physiologically disturbed in a way that impairs the wave guide function of the outer segments. The LDCR in this study were seen as very distinct localized changes that did not grossly impact vision, although functional impairment and changes in metabolism of the cones may have been more widespread and could be related to cone defects that have been reported in diabetics 23,56,57 and may be related to functional changes in diabetes, 27–32 which are consistent with the treatment of diabetes as a neurodegenerative disorder. 1–4 …”

Section: Discussionsupporting

confidence: 79%

Alterations to the Foveal Cone Mosaic of Diabetic Patients

Sawides

Sapoznik

Castro

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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PurposeWe measured localized changes occurring in the foveal cone photoreceptors and related defects in the cone mosaic to alterations in the nearby retinal vasculature.MethodsThe central 4° of the retina of 54 diabetic (53.7 ± 12.5 years) and 85 control (35.8 ± 15.2 years) participants were imaged with the Indiana adaptive optics scanning laser ophthalmoscope. Foveal cones and overlying retinal capillaries were imaged and infrared scanning laser ophthalmoscopy (IR SLO) images and optical coherence tomography (OCT) B-scans were obtained. Follow-up imaging sessions were performed with intervals from 4 to 50 months for 22 of the 54 diabetic participants.ResultsThe foveal cone mosaics of 49 of 54 diabetic participants were of sufficient quality to assess the absence or presence of small localized defects in the cone mosaic. In 13 of these 49 diabetic participants we found localized defects, visualized as sharp-edged areas of cones with diminished reflectivity. These small, localized areas ranged in size from 10 × 10 μm to 75 × 30 μm. Of these 13 participants with cone defects, 11 were imaged over periods from 4 to 50 months and the defects remained relatively stable. These dark regions were not shadows of overlying retinal vessels, but all participants with these localized defects had alterations in the juxtafoveal capillary network.ConclusionsThe foveal cone mosaic can show localized areas of dark cones that persist over time, that apparently correspond to either missing or nonreflecting cones, and may be related to local retinal ischemia.

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Section: Discussionsupporting

confidence: 79%

Alterations to the Foveal Cone Mosaic of Diabetic Patients

Sawides

Sapoznik

Castro

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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“…Diabetes has also been reported to cause a reduction in the length of the rod outer segments in male Sprague–Dawley rats over a study duration of 24 weeks. Morphological signs of degeneration in the outer segments of rods, most M‐cones and some S‐cones has been reported in Male Wistar and Sprague–Dawley rats killed 12 weeks after the induction of diabetes.…”

Section: Morphological Changes To Photoreceptors Retinal Pigment Epimentioning

confidence: 98%

“…Not all studies show photoreceptor death in diabetes. Studies of male Wistar and Sprague–Dawley rats diabetic for 12 weeks reported that retinal thickness, the number of apoptotic cells, and the density of cones expressing middle (M)‐ and shortwave (S)‐sensitive opsins were similar in diabetic and control retinas. In male C57BL/6J mice diabetic for 2 months, no significant difference in the number of layers in the outer nuclear layer was detected.…”

Section: Morphological Changes To Photoreceptors Retinal Pigment Epimentioning

confidence: 99%

Photoreceptors in diabetic retinopathy

Kern

Berkowitz

2015

J of Diabetes Invest

100

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Although photoreceptors account for most of the mass and metabolic activity of the retina, their role in the pathogenesis of diabetic retinopathy has been largely overlooked. Recent studies suggest that photoreceptors might play a critical role in the diabetes-induced degeneration of retinal capillaries, and thus can no longer be ignored. The present review summarizes diabetes-induced alterations in photoreceptor structure and function, and provides a rationale for further study of a role of photoreceptors in the pathogenesis of the retinopathy.

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“…Interestingly, the foveal cones appear to be mostly affected revealing a loss of approximately 30% of the M-cones 7 weeks after type 2 diabetes was induced in the animals [46]. Studies in rats also have shown alterations in the photoreceptor outer segments with the S-cones and the M-cones most severely affected [47].…”

Section: Outcomes Of Irbp's Decreased Levels In Diabetesmentioning

confidence: 99%

Interphotoreceptor Retinoid-Binding Protein Implications in Diabetic Retinopathy

Bermea¹

2018

Early Events in Diabetic Retinopathy and Intervention Strategies

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The interphotoreceptor retinoid-binding protein (IRBP) is the most abundant protein in the interphotoreceptor matrix (IPM) and its levels decrease beginning in the early stages of diabetes. IRBP participates in the delivery of retinoids between retinal cells to carry out the visual cycle and also protects those retinoids against degradation in the IPM. IRBP deficiency is related to several conditions such as retinitis pigmentosa, cone-rod dystrophy, increased oxidative stress in the photoreceptors, and myopia. Decreased IRBP levels in diabetes could be due to the secretion of inflammatory cytokines and a direct effect of hyperglycemia on the photoreceptors. It is known that prior to the occurrence of vascular changes in diabetic retina, electrophysiological alterations occur on early potentials. Alterations on the photoreceptor outer segments and increased oxidative stress indicate an important affliction of the photoreceptors from early stages. Due to the importance of IRBP in photoreceptor wellness, its decreased levels may be linked to early photoreceptor affection. More studies are required to describe in detail the whole impact that decreased levels of IRBP in diabetes may have.

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Pathologic Alterations of the Outer Retina in Streptozotocin-Induced Diabetes

Cited by 64 publications

References 55 publications

Alterations to the Foveal Cone Mosaic of Diabetic Patients

Alterations to the Foveal Cone Mosaic of Diabetic Patients

Photoreceptors in diabetic retinopathy

Interphotoreceptor Retinoid-Binding Protein Implications in Diabetic Retinopathy

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