DRC researchers publish major breakthrough in understanding how diabetes induces eye damage

Scientists have long known that patients with diabetes mellitus—both Type 1 and Type 2—are at high risk for developing diabetic retinopathy, which is the most common cause of irreversible blindness in adults. Vision loss occurs because of microvascular damage to the retina. People with diabetes are typically not aware that they are also at risk for developing retinal diabetic neuropathy, which is the loss of nerve cells in the retina. For many years, scientists believed patients developed retinopathy and, as a result of the damage to the blood vessels, later developed neuropathy. Doctors were focusing on early detection and treatment of retinopathy to prevent blindness, which they thought would then prevent the damage caused by neuropathy. However, in a new study in the online journal PNAS, researchers in the Fraternal Order of Eagles Diabetes Research Center discovered that the sequence of events occurring in the retina is just the opposite. “What we’re finding here, unfortunately, is that the nerve damage actually does come first, before the vessel damage,” says Dr. Michael Abramoff, professor of ophthalmology and visual sciences and senior author on the study. “Even people with diabetes who never get retinopathy can still develop this damage, and after many years, damage may be severe, similar to glaucoma.” Dr. Elliott Sohn, associate professor of ophthalmology and visual sciences, is a first author on the study and other UI researchers include Chunhua Jiao, Woojin Jeong, Allison Garmager, Murat Kucukevcilioglu, Robert Mullins, and Markus Kuehn. Milan Sonka, from the Iowa Institute for Biomedical Imaging and the UI College of Engineering, also contributed to the study.

Sohn EH, van Dijk HW, Jiao C, Kok PH, Jeong W, Demirkaya N, Garmager A, Wit F, Kucukevcilioglu M, van Velthoven ME, DeVries JH, Mullins RF, Kuehn MH, Schlingemann RO, Sonka M, Verbraak FD, Abràmoff MD. Retinal neurodegeneration may precede microvascular changes characteristic of diabetic retinopathy in diabetes mellitus. Proc Natl Acad Sci U S A. 2016 Apr 25. pii: 201522014. 

Monday, May 9, 2016