Diabetic retinopathy (eye disease) results in visual loss though two main mechanisms. In one condition, diabetic macular edema (DME), the small blood vessels of the retina leak fluid into histiocytoma dog removal cost the macula in the center of the retina, impairing vision. In the other condition, proliferative diabetic retinopathy (PDR), blood vessels in the retina grow where they should not.
Researchers in the section conduct studies to understand the basic histiocytoma dog removal cost molecular mechanisms underlying retinal vascular disease—in particular, the activity of growth factors in PDR and DME—and use results to design animal and clinical trials, which are now investigating the effects of oral protein kinase histiocytoma dog removal cost C inhibitors, growth factor inhibitors, antioxidants and anti-proliferative agents.
In pioneering work, researchers defined the role of vascular endothelial growth factor (VEGF), hepatocyte growth factor, pigment epithelial-derived factor and others, and tested novel inhibitors of these pathways in cells, animals and humans. In addition, they identified new areas on the genes that control the histiocytoma dog removal cost expression of these molecules. Further studies show that the stretching of blood vessels during histiocytoma dog removal cost high blood pressure alters the expression of these factors—findings that may lead to future treatments for diabetic retinopathy histiocytoma dog removal cost exacerbated by hypertension.
The section is internationally recognized for its expertise in novel histiocytoma dog removal cost imaging methods. The eye is unique in that its vasculature, microvasculature and neuronal systems can be visualized directly in vivo, enabling noninvasive evaluation of biological processes. For example, a retinal imaging system called the joslin vision network (JVN) uses a combination of video cameras and computers to image histiocytoma dog removal cost the back of the eye without dilating the pupil. These stereoscopic color images compare favorably with a retinal specialist histiocytoma dog removal cost exam, and can accurately diagnose retinopathy long before symptoms appear and histiocytoma dog removal cost in locations where access to ophthalmology care may be limited. JVN is deployed in more than 70 sites in 20 histiocytoma dog removal cost states. Surprisingly, in more than 50 percent of patients with diabetes who histiocytoma dog removal cost do not have retinopathy, the JVN identifies eye disease that needs evaluation.
The section also collaborates with the creators of an innovative histiocytoma dog removal cost imaging device called the ultra high-resolution ocular coherence tomogram, which provides a cross section of the retina revealing individual histiocytoma dog removal cost cell layers. Researchers are evaluating these images to determine if they provide histiocytoma dog removal cost additional or earlier information about patients who have or may histiocytoma dog removal cost develop eye disease. Collaborating for a cure
Building on their earlier findings—that VEGF is elevated in retinal and ocular fluids in histiocytoma dog removal cost people with diabetic retinopathy—investigators are collaborating with colleagues in the section on vascular histiocytoma dog removal cost cell biology to determine which factors regulate VEGF expression in histiocytoma dog removal cost the eye and how vascular wall stretching affects its regulation. Another collaboration involves studies of protein kinase C inhibitors to histiocytoma dog removal cost determine whether they can slow the progression of diabetic retinopathy, reduce macular edema and/or preserve vision. A further collaboration, which also includes beth israel deaconess medical center, is evaluating whether changes in electrophysiology of the eye can histiocytoma dog removal cost help in the detection of early or incipient diabetic neuropathy histiocytoma dog removal cost (nerve damage).
The collaborative approach is also undertaken at the national level histiocytoma dog removal cost via the diabetic retinopathy clinical research network, a national eye institute-sponsored network of over 100 U.S. Sites dedicated to rigorous clinical trials of new therapeutic approaches histiocytoma dog removal cost for diabetic retinopathy and diabetic macular edema. A member of the section is the founding network chairman histiocytoma dog removal cost for this initiative.
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