Biomedical subjects
Publications and source records attributed to Thomas W Gardner.
Diabetic retinopathy, the most frequent complication of diabetes and leading cause of vision loss, involves vascular and neural damage in the retina. Insulin and IGF-1 signaling are now shown to contribute to retinal neovascularization, in part, by modulating the expression of various vascular mediators.
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PURPOSE: To report the case of a 64-year-old woman with peripheral neuropathy, organomegaly, endocrinopathy, monoclonal gammopathy, and skin changes (POEMS) syndrome, Castleman disease, optic nerve drusen, and peripapillary choroidal neovascularization. METHODS: Interventional case report. Clinical practice. RESULTS: Laser photocoagulation resolved the peripapillary choroidal neovascularization. CONCLUSION: This is the first documented case of optic disk drusen and peripapillary choroidal neovascularization associated with POEMS.
Retinal microvascular dysfunction in diabetes is a major component of diabetic retinopathy. This review highlights recent observations regarding the cellular anatomy that contributes to the blood-retinal barrier and its breakdown, the alterations of macroglial, neuronal, and microglial cells in diabetes, and how these changes lead to loss of vision. In addition, the effects of systemic pathophysiologic influences, including metabolic control, blood pressure, and fluid volume on the formation of diabetic macular edema are discussed. Finally, an overview of inflammatory mechanisms and responses in the retina in diabetes is provided. Together, these new observations provide a broader clinical and research perspective on diabetic retinal vascular dysfunction than previously considered, and provide new avenues for improved treatments to prevent loss of vision.
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