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Neurodegeneration in diabetic retinopathy: does it really matter?
Simó R, Stitt AW, Gardner TW.. Diabetologia, 2018-07-20
Topic: Risk, prevention and care in population studies
The concept of diabetic retinopathy as a microvascular disease has evolved, in that it is now considered a more complex diabetic complication in which neurodegeneration plays a significant role. In this article we provide a critical overview of the role of microvascular abnormalities and neurodegeneration in the pathogenesis of diabetic retinopathy. A special emphasis is placed on the pathophysiology of the neurovascular unit (NVU), including the contributions of microvascular and neural elements. The potential mechanisms linking retinal neurodegeneration and early microvascular impairment, and the effects of neuroprotective drugs are summarised. Additionally, we discuss how the assessment of retinal neurodegeneration could be an important index of cognitive status, thus helping to identify individuals at risk of dementia, which will impact on current procedures for diabetes management. We conclude that glial, neural and microvascular dysfunction are interdependent and essential for the development of diabetic retinopathy. Despite this intricate relationship, retinal neurodegeneration is a critical endpoint and neuroprotection, itself, can be considered a therapeutic target, independently of its potential impact on microvascular disease. In addition, interventional studies targeting pathogenic pathways that impact the NVU are needed. Findings from these studies will be crucial, not only for increasing our understanding of diabetic retinopathy, but also to help to implement a timely and efficient personalised medicine approach for treating this diabetic complication.
Key findings
- The concept of diabetic retinopathy as a microvascular disease has evolved, in that it is now considered a more complex diabetic complication in which neurodegeneration plays a significant role.
- We conclude that glial, neural and microvascular dysfunction are interdependent and essential for the development of diabetic retinopathy.
Why it matters
This review argues that retinal neurodegeneration is a critical endpoint in diabetic retinopathy and that neuroprotection itself can be considered a therapeutic target. It also suggests that assessing retinal neurodegeneration could help identify people at risk of dementia, but notes that interventional studies targeting these pathways are still needed.
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Study details
- Evidence strengthLow
How this study scored 56/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Diabetologia) |
| Journal's citation record | 3 / 4 | Diabetologia: journal h-index 337 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 2 / 5 | 2018 — within 10 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 593 times (OpenAlex, 2026-10-10) |
| Citations per year | 5 / 5 | 59.3 citations a year over 10 year(s) since 2018 |
| Impact for its field and year | 6 / 6 | Cited 43.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 4 / 4 | Cited 230 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Thomas W. Gardner: h-index 72 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Michigan: institution h-index 2,240 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 7 institution(s) in 3 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 30030554) |
| Free to read | 2 / 2 | Free to read |
| Total | 56 / 100 | — |
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Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Simó, R., Stitt, A. W., & Gardner, T. W. (2018). Neurodegeneration in diabetic retinopathy: does it really matter? Diabetologia. https://doi.org/10.1007/s00125-018-4692-1
Vancouver
Simó R, Stitt AW, Gardner TW. Neurodegeneration in diabetic retinopathy: does it really matter? Diabetologia. 2018. doi:10.1007/s00125-018-4692-1. PMID: 30030554.
BibTeX
@article{simo2018-30030554,
author = {Simó, R. and Stitt, A. W. and Gardner, T. W.},
title = {{Neurodegeneration in diabetic retinopathy: does it really matter?}},
journal = {Diabetologia},
year = {2018},
doi = {10.1007/s00125-018-4692-1},
pmid = {30030554},
url = {https://doi.org/10.1007/s00125-018-4692-1}
}
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