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Photoreceptor responses to light in the pathogenesis of diabetic retinopathy

Published online by Cambridge University Press:  14 September 2020

Shahriyar P. Majidi Open the ORCID record for Shahriyar P. Majidi [Opens in a new window]  and
Rithwick Rajagopal Open the ORCID record for Rithwick Rajagopal [Opens in a new window]
Shahriyar P. Majidi
Affiliation:
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri MD-PhD Program, Washington University School of Medicine, St. Louis, Missouri, 63110, USA
Rithwick Rajagopal*
Affiliation:
Department of Ophthalmology and Visual Sciences, Washington University School of Medicine, St. Louis, Missouri
*
Address correspondence to: Rithwick Rajagopal, E-mail: rajagopalr@wustl.edu
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Abstract

Vision loss, among the most feared complications of diabetes, is primarily caused by diabetic retinopathy, a disease that manifests in well-recognized, characteristic microvascular lesions. The reasons for retinal susceptibility to damage in diabetes are unclear, especially considering that microvascular networks are found in all tissues. However, the unique metabolic demands of retinal neurons could account for their vulnerability in diabetes. Photoreceptors are the first neurons in the visual circuit and are also the most energy-demanding cells of the retina. Here, we review experimental and clinical evidence linking photoreceptors to the development of diabetic retinopathy. We then describe the influence of retinal illumination on photoreceptor metabolism, effects of light modulation on the severity of diabetic retinopathy, and recent clinical trials testing the treatment of diabetic retinopathy with interventions that impact photoreceptor metabolism. Finally, we introduce several possible mechanisms that could link photoreceptor responses to light and the development of retinal vascular disease in diabetes. Collectively, these concepts form the basis for a growing body of investigative efforts aimed at developing novel pharmacologic and nonpharmacologic tools that target photoreceptor physiology to treat a very common cause of blindness across the world.

Keywords

Diabetic retinopathyphotoreceptormetabolismphototransductionlight deprivationvisual cycle
Type
Review Article
Information
Visual Neuroscience , Volume 37 , 2020 , E007
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Copyright
© The Author(s), 2020. Published by Cambridge University Press

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