6/13/2023 0 Comments Beyond eyes download![]() ![]() The presence of hard exudates (a component of non-proliferative diabetic retinopathy) has been particularly associated with CVD and plaque formation. The main structural retinal fingerprints associated with CVD and stroke are displayed in Fig. For instance, anti-vascular-endothelial-growth-factor (VEGF) agents are effective for treating proliferative diabetic retinopathy but exert a deleterious effect in coronary arteries by inhibiting the re-vascularisation after ischaemia. Despite these similarities, the vascular beds in the blood vessels in the heart show important differences to those in the retina that could affect the response to treatment approaches. Maladaptive vascular reparatory mechanisms may also play a role a decrease in the number of endothelial colony forming cells (ECFCs) not only predict macroangiopathy but also diabetic retinopathy. This change in plaque phenotype results in a more inflamed and unstable plaque, favouring plaque rupture and a poor outcome of cardiovascular events. In this regard, recent evidence indicates that, in individuals with type 2 diabetes, the vasa vasorum (a network of small blood vessels that supply the walls of large blood vessels) present evolutionary changes similar to those observed in the retina: an initial stage in which endothelial dysfunction and loss of capillaries predominate, and more advanced stages in which ischaemia plays a key role, leading to angiogenesis and inflammation in response to the progressive enlargement of the necrotic core within the plaque. Therefore, screening for CVD should be prioritised in patients with diabetic retinopathy.Īlthough the underlying molecular mechanisms linking diabetic retinopathy and CVD are still a matter of debate, there are notable similarities in their pathophysiology. ![]() In addition, the presence and degree of diabetic retinopathy has recently been found to be an independent and powerful predictor of subclinical CVD. There is epidemiological evidence showing that either diabetic retinopathy or diabetic macular oedema (DMO) independently predict incident coronary heart disease, fatal CVD, heart failure and stroke. ![]()
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