Diabetic Retinopathy in the Aging Population: A Perspective of Pathogenesis and Treatment

Figures & data

Table 1 Structural Retinal Changes with Aging

Retinal Component	Change from Aging
Thickness	Decreases, especially the Inner Nuclear Layer.^Citation16,Citation17
Macular Blood Flow	Reduced by 20% on average.^Citation20
Microglia	Less motile, slower response time to injury, denser, with a smaller dendritic arbor.^Citation23
RPE	Decreased melanin production, increased lipofuscin accumulation.^Citation23,Citation24
Müller Cells	More susceptible to oxidative stress.^Citation20,Citation24

Figure 1 Interconnected pathways of DR and areas of susceptibility for the elderly.

Notes: All the above pathways contribute to DR progression in unique ways. They have some mechanisms that can exacerbate the effects of other pathways. Namely, many of the pathways increase VEGF production, which could impact the role of the VEGF pathway and take advantage of some age-related changes that leave the retina more susceptible to DR damage.

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