Photoreceptor cells and RPE contribute to the development of diabetic retinopathy.

Diabetic retinopathy (DR) is a leading cause of blindness. It has long been regarded as vascular disease, but work in the past years has shown abnormalities also in the neural retina. Unfortunately, research on the vascular and neural abnormalities have remained largely separate, instead of being integrated into a comprehensive view of DR that includes both the neural and vascular components. Recent evidence suggests that the most predominant neural cell in the retina (photoreceptors) and the adjacent retinal pigment epithelium (RPE) play an important role in the development of vascular lesions characteristic of DR. This review summarizes evidence that the outer retina is altered in diabetes, and that photoreceptors and RPE contribute to retinal vascular alterations in the early stages of the retinopathy. The possible molecular mechanisms by which cells of the outer retina might contribute to retinal vascular damage in diabetes also are discussed. Diabetes-induced alterations in the outer retina represent a novel therapeutic target to inhibit DR.

糖尿病视网膜病变（DR）是导致失明的主要原因。长期以来它一直被视为血管疾病，但过去几年的研究表明神经视网膜也存在异常。不幸的是，对血管和神经异常的研究在很大程度上是相互独立的，而没有整合到一个包含神经和血管成分的全面的糖尿病视网膜病变观点中。近期的证据表明，视网膜中最主要的神经细胞（光感受器）和相邻的视网膜色素上皮（RPE）在糖尿病视网膜病变特征性血管病变的发展中起重要作用。这篇综述总结了糖尿病中视网膜外层发生改变以及光感受器和视网膜色素上皮在视网膜病变早期阶段导致视网膜血管改变的证据。还讨论了视网膜外层细胞可能导致糖尿病视网膜血管损伤的分子机制。糖尿病诱导的视网膜外层改变是抑制糖尿病视网膜病变的一个新的治疗靶点。