Diabetic retinopathy (DR) is a complex multifactorial disease and one of the leading causes of visual impairment worldwide. DR pathogenesis is still not completely understood and, even if studies performed in the past...Diabetic retinopathy (DR) is a complex multifactorial disease and one of the leading causes of visual impairment worldwide. DR pathogenesis is still not completely understood and, even if studies performed in the past focused on microvascular dysfunction as the main event, growing body of scientific evidence has demonstrated an important role of inflammation and neurodegeneration in the onset and progression of DR. This review summarizes current literature on the role of inflammation in the pathogenesis and progression of DR. In particular, it focuses on clinical inflammatory biomarkers detectable with non-invasive retinal imaging, suggestive of a local inflammatory condition. Current available treatments are applicable only at advanced stages of disease, therefore, there is the need to detect biomarkers of subclinical or early DR that can help in DR management before irreversible damage occurs. A better understanding of inflammatory pathways involved in DR may permit to implement more specific and personalized therapeutic strategies and clinical biomarkers may be a helpful tool in the everyday clinical practice to direct the patient to the most appropriate treatment option.展开更多
Neuroretinitis is characterized by optic disc swelling with macular star,and affects 1%-2%of the patients with Bartonella henselae infection.This condition needs to be considered in the differential diagnosis of unila...Neuroretinitis is characterized by optic disc swelling with macular star,and affects 1%-2%of the patients with Bartonella henselae infection.This condition needs to be considered in the differential diagnosis of unilateral optic neuropathy in young adults.A 44-year-old woman presented with a progressive visual loss in right eye that was described as a central scotoma with altered color perception.Medical history was negative except for Hashimoto's thyroiditis.The examination evidenced a relative afferent pupillary defect in right eye and marked papillary oedema involving the macular region.Brain and orbits magnetic resonance imaging were normal,and fundoscopy showed star-shaped hard exudates.Autoimmune and infective screening revealed IgM and IgG antibodies against Bartonella henselae,suggesting for recent cat-scratch disease.She was treated with high-dose intravenous steroids and doxycycline.One month later she fully recovered,and she had no relapses.We diagnosed a Bartonella henselae neuroretinitis(finally the patient recalled she had stroked stray cats,not being scratched).In conclusion time course and absence of pain differentiate neuroretinitis from other optic neuropathies.Fundoscopic image of macular star is a clue for diagnosis,and visual recovery is usually excellent.展开更多
文摘Diabetic retinopathy (DR) is a complex multifactorial disease and one of the leading causes of visual impairment worldwide. DR pathogenesis is still not completely understood and, even if studies performed in the past focused on microvascular dysfunction as the main event, growing body of scientific evidence has demonstrated an important role of inflammation and neurodegeneration in the onset and progression of DR. This review summarizes current literature on the role of inflammation in the pathogenesis and progression of DR. In particular, it focuses on clinical inflammatory biomarkers detectable with non-invasive retinal imaging, suggestive of a local inflammatory condition. Current available treatments are applicable only at advanced stages of disease, therefore, there is the need to detect biomarkers of subclinical or early DR that can help in DR management before irreversible damage occurs. A better understanding of inflammatory pathways involved in DR may permit to implement more specific and personalized therapeutic strategies and clinical biomarkers may be a helpful tool in the everyday clinical practice to direct the patient to the most appropriate treatment option.
文摘Neuroretinitis is characterized by optic disc swelling with macular star,and affects 1%-2%of the patients with Bartonella henselae infection.This condition needs to be considered in the differential diagnosis of unilateral optic neuropathy in young adults.A 44-year-old woman presented with a progressive visual loss in right eye that was described as a central scotoma with altered color perception.Medical history was negative except for Hashimoto's thyroiditis.The examination evidenced a relative afferent pupillary defect in right eye and marked papillary oedema involving the macular region.Brain and orbits magnetic resonance imaging were normal,and fundoscopy showed star-shaped hard exudates.Autoimmune and infective screening revealed IgM and IgG antibodies against Bartonella henselae,suggesting for recent cat-scratch disease.She was treated with high-dose intravenous steroids and doxycycline.One month later she fully recovered,and she had no relapses.We diagnosed a Bartonella henselae neuroretinitis(finally the patient recalled she had stroked stray cats,not being scratched).In conclusion time course and absence of pain differentiate neuroretinitis from other optic neuropathies.Fundoscopic image of macular star is a clue for diagnosis,and visual recovery is usually excellent.
