einstein (São Paulo). 17/Dec/2020;19:eED6110.
Diabetic retinopathy: a neuropathy
DOI: 10.31744/einstein_journal/2021ED6110
Neurodegeneration
The pathophysiology of diabetic retinopathy is related to the apoptosis of ganglion and amacrine and Müller cells of the retina, due to an accumulation of glutamate, which leads to a picture of neurodegeneration and reduction of the layer of nerve fibers and ganglion cells.()
The pathophysiology of glutamate accumulation is related to dysfunction of the glutamine-synthetase enzyme of Müller cells, which reduces its ability to oxidize glutamate and to remove retinal glutamate by the glia cells. An increase in glutamate concentration leads to cell death due to an intracellular increase in calcium. Diabetes also induces activation of microglia cells, located inside the retina, which migrate to the subretinal space and release cytokines, contributing to neuronal cell death.()
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