Although diabetic retinopathy (DR) is clinically diagnosed as a vascular disease, many studies find retinal neuronal and visual dysfunction before the onset of vascular DR. This suggests that DR should be viewed as a neurovascular disease. Prior to the onset of DR, human patients have compromised electroretinograms that indicate a disruption of normal function, particularly in the inner retina. They also exhibit reduced contrast sensitivity. These early changes, especially those due to dysfunction in the inner retina, are also seen in rodent models of diabetes in the early stages of the disease. Rodent models of diabetes exhibit several neuronal mechanisms, such as reduced evoked GABA release, increased excitatory glutamate signaling, and reduced dopamine signaling, that suggest specific neuronal deficits. This suggests that understanding neuronal deficits may lead to early diabetes treatments to ameliorate neuronal dysfunction.

中文翻译：

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糖尿病引起的视觉功能障碍

尽管糖尿病视网膜病变（DR）在临床上被诊断为一种血管疾病，但许多研究发现在血管性DR发病之前视网膜神经元和视觉功能障碍。这表明 DR 应被视为一种神经血管疾病。在 DR 发生之前，人类患者的视网膜电图已受损，表明正常功能受到破坏，尤其是视网膜内层。它们还表现出对比敏感度降低。这些早期变化，尤其是由于内视网膜功能障碍引起的变化，在疾病早期阶段的糖尿病啮齿动物模型中也可见到。糖尿病啮齿动物模型表现出多种神经元机制，例如诱发的 GABA 释放减少、兴奋性谷氨酸信号传导增加和多巴胺信号传导减少，这些都表明存在特定的神经元缺陷。这表明了解神经元缺陷可能会导致早期糖尿病治疗以改善神经元功能障碍。