Advances in understanding the pathology of diabetic retinopathy

Abstract

Diabetic retinopathy (DR) is a common complication of diabetes and a significant cause of blindness among working-age adults. Traditionally, DR has been considered to be a microvascular disease. As research has progressed, scientists now believe that pathological changes in retinal neurons occur before the appearance of microangiopathy in diabetic patients and are involved in the progression of microangiopathy. Retinal vascular tissue is closely associated with neurons and glial cells, forming the neurovascular unit (NVU) structure, which is thought to be the pathological basis for developing DR, a neurovascular disease caused by NVU damage. This review briefly summarizes the advances in the pathology of DR based on the NVU, focusing on retinal microangiopathy, neurodegeneration, immune dysregulation, retinal pigment epithelium, and choroidal lesions in DR.