The role of inflammation in diabetic retinopathy in patients with type II diabetes; potential therapeutic perspectives

Diabetic retinopathy is one of the major causes of visual impairment and blindness in adult population. The pathology is complex, the metabolic changes induced by the hyperglycemic environment leading to neurodegeneration, microvascular damage, with secondary ischemic and inflammatory changes in the retina. This review aims to update the literature data related to the role of inflammation in the onset and progression of diabetic retinopathy. Thus, the molecular and biochemical mechanisms triggered by excess glucose increase the expression of genes involved in inflammatory processes, which leads to the synthesis of inflammatory cytokines such as Il1, Il6, TNF alpha as well as complement activation. Furthermore, recent evidence has demonstrated that both systemic and ocular prolonged inflammation are correlated with the progression of diabetic retinopathy. In conclusion, preventing and/or reducing the progression of diabetic retinopathy requires both rigorous glycemic control in diabetic patients and targeted interference of the specific inflammatory pathways involved.