The importance of glial cells in the homeostasis of the retinal microenvironment and their pivotal role in the course of diabetic retinopathy

Abstract Diabetic retinopathy (DR) is a remarkable microvascular complication of diabetes and it has been considered the leading cause of legal blindness in working-age adults in the world. Several overlapping and interrelated molecular pathways are involved in the development of this disease. DR is staged into different levels of severity, from the nonproliferative to the advanced proliferative form. Over the years the progression of DR evolves through a series of changes involving distinct types of specialized cells: neural, vascular and glial. Prior to the clinically observable vascular complications, hyperglycemia and inflammation affect retinal glial cells which undergo a wide range of structural and functional alterations. In this review, we provide an overview of the status of macroglia and microglia in the course of DR, trying to briefly take into account the complex biochemical mechanisms that affect the intimate relationship among neuroretina, vessels and glial cells

Eredo-distrofia tapeto-retinica e miopia degenerativa: variabilità fenotipica familiare in tre pazienti di razza caucasica

Descriviamo gli aspetti clinici di tre membri della stessa famiglia affetti da ipovisione centrale di diversa gravità, associata a difetti campimetrici in entrambi gli occhi. Ciascun paziente è stato sottoposto a valutazione oftalmologica, esame del campo visivo computerizzato, fluorangiografia retinica ed elettroretinogramma dinamico. Le indagini diagnostico-strumentali hanno comprovato, bilateralmente, la presenza di: miopia degenerativa nella madre di 73 anni e distrofie tapeto-retiniche nei due figli maschi rispettivamente di 43 e 37 anni. L’albero genealogico familiare appare indicativo di un’ereditarietà di tipo X-linked. Queste osservazioni cliniche sottolineano l’esistenza, all’interno dei membri di una stessa famiglia, di una notevole eterogeneità fenotipica. Tali patologie familiari rendono auspicabile, nel prossimo futuro, la possibilità di effettive identificazioni del gene-malattia mediante ricerche molecolari con tecniche di macro-array ed eventuale analisi di linkage in pazienti con eredo-distrofie tapeto-retiniche. We describe the clinical aspects of three members of a family with central visual impairment of varying severity associated with visual field defects in both eyes. Each patient underwent ophthalmologic evaluation, computerized visual field, fluorescein angiography and dynamic electroretinography. These diagnostic examinations have bilaterally documented the presence of: degenerative myopia (mother of 73 years) and hereditary tapeto-retinal dystrophies in the two sons (43 and 37 years respectively). The family pedigree is indicative of an X-linked inheritance. These clinical observations emphasize the existence, within the members of the same family, a remarkable phenotypic heterogeneity. These familial diseases warrant, in the near future, an effective opportunity of identification of the causative gene by molecular researches including macro-array technique and possible linkage analyses in patients with hereditary tapeto-retinal dystrophies