Department of Optometry and Vision Sciences Cardiff University, UK

Correspondence to: Professor M Boulton, Department of Optometry and Vision Sciences Cardiff University Redwood Building King Edward VII Avenue Cathays Park Cardiff CF10 3NB Wales, UK Tel: +44 (0)29 2087 5100 Fax: +44 (0)29 2087 4859 E-mail: BoultonM@cardiff.ac.uk

Hyperglycaemia appears to be a critical factor in the aetiology of diabetic retinopathy and initiates downstream events including: basement membrane thickening, pericyte drop out and retinal capillary non-perfusion. More recently, focus has been directed to the molecular basis of the disease process in diabetic retinopathy. Of particular importance in the development and progression of diabetic retinopathy is the role of growth factors (eg vascular endothelial growth factor, placenta growth factor and pigment epithelium-derived factor) together with specific receptors and obligate components of the signal transduction pathway needed to support them. Despite these advances there are still a number of important questions that remain to be answered before we can confidently target pathological signals. How does hyperglycaemia regulate retinal vessels? Which growth factors are most important and at what stage of retinopathy do they operate? What is the preferred point in the growth factor signalling cascade for therapeutic intervention? Answers to these questions will provide the basis for new therapeutic interventions in a debilitating ocular condition.

Eye (2002) 16, 242-260. DOI: 10.1038/sj/eye/6700133

diabetic retinopathy; hyperglycaemia; retina endothelial cells; pericytes; hypoxia; neovascularization; growth factor