| ISSN |
2307-8960 (online) |
| Open Access |
This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
| Copyright |
©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc. |
| Article Reprints |
For details, please visit: http://www.wjgnet.com/bpg/gerinfo/247
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| Permissions |
For details, please visit: http://www.wjgnet.com/bpg/gerinfo/207
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| Publisher |
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA |
| Website |
http://www.wjgnet.com |
| Category |
Ophthalmology |
| Manuscript Type |
Minireviews |
| Article Title |
Underlying cause of diabetic retinopathy: Metabolic instability
|
| Manuscript Source |
Invited Manuscript |
| All Author List |
Francesco Cappellani, Matteo Capobianco, Francesco Leonforte, Alessandro Avitabile, Federico Visalli, Marieme Khouyyi, Rosa Giglio, Leandro Inferrera, Daniele Tognetto, Fabiana D’Esposito, Caterina Gagliano and Marco Zeppieri |
| Funding Agency and Grant Number |
|
| Corresponding Author |
Marco Zeppieri, Consultant, MD, PhD, Postdoc, Department of Ophthalmology, University Hospital of Udine, p. le S. Maria della Misericordia 15, Udine 33100, Italy. mark.zeppieri@asufc.sanita.fvg.it |
| Key Words |
Metabolic instability; Diabetic retinopathy; Glycemic variability; Metabolic memory; Continuous glucose monitoring; Oxidative stress; Neurovascular unit |
| Core Tip |
Diabetic retinopathy is becoming acknowledged as a result of dynamic metabolic stress rather than merely prolonged hyperglycemia. Variations in glucose levels, repeated glycemic fluctuations, and hypoglycemia collectively affect the retinal neurovascular unit, promoting oxidative stress, inflammation, mitochondrial dysfunction, and epigenetic reprogramming. These pathways may expedite microvascular and neuronal damage despite seemingly acceptable average glucose indices. Recognizing diabetic retinopathy as a marker of metabolic instability complicates traditional risk assessment and underscores the need for new, sensitive, temporally resolved metabolic indicators. |
| Publish Date |
2026-04-15 07:40 |
| Citation |
Cappellani F, Capobianco M, Leonforte F, Avitabile A, Visalli F, Khouyyi M, Giglio R, Inferrera L, Tognetto D, D’Esposito F, Gagliano C, Zeppieri M. Underlying cause of diabetic retinopathy: Metabolic instability. World J Clin Cases 2026; 14(12): 120247 |
| URL |
https://www.wjgnet.com/2307-8960/full/v14/i12/120247.htm |
| DOI |
https://dx.doi.org/10.12998/wjcc.v14.i12.120247 |
