Skip to main content

Table 1 Pathological features of the neurovascular unit in diabetic retinopathy (DR)

From: Neurovascular unit in diabetic retinopathy: pathophysiological roles and potential therapeutical targets

Pathological Changes Characteristics References
Neurodegeneration Loss of retinal ganglion cells and amacrine cells [36,37,38,39,40]
Decrease of NFL, IPL and INL [37, 38, 40,41,42]
Reactive gliosis Activation of astrocytes and Müller cells [15, 43, 44]
Death of Müller cells [45]
Microvascular Pathology Impaired neurovascular coupling [46, 47]
Basement membrane thickening [48,49,50]
Loss of pericytes [16, 51, 52]
Formation of microaneurysms [53, 54]
Reduction of tight junctions between endothelial cells and apoptosis of endothelial cells [52, 55,56,57]
Breakdown of inner BRB [55,56,57,58]
Immuno-inflammation Leukostasis [59,60,61]
Activation of microglial cells [62,63,64]
Production of inflammatory cytokines (TNFα, IL-1β, IL-6, IL-8, MCP-1, VEGF) [65,66,67,68,69]
RPE and Choroid Pathology Damage of transportation of ions and water in RPE cells [70, 71]
Decrease of 11-cis retinal produced in RPE cells [71, 72]
Upregulation of cytokines secreted by RPE cells (VEGF, PDGF, TNFα, IL-6, IL-8,) [73]
Reduction of tight junctions between RPE cells [34, 74,75,76]
Breakdown of outer BRB [34, 74,75,76]
Choroidal degeneration (decreased choroidal thickness, increased Bruch’s membrane thickness, aneurysms, choroidal neovascularization) [77,78,79]
  1. NFL= nerve fiber layer; IPL= inner plexiform layer; INL= inner nuclear layer; BRB= blood-retinal barrier; TNFα= tumor necrosis factor alpha; IL-1β= interleukin-1beta; IL-6= interleukin-6; IL-8= interleukin-8; MCP-1= monocyte chemoattractant protein 1; VEGF= vascular endothelial growth factor; RPE= retinal pigment epithelium; PDGF= platelet-derived growth factor