Evidence map›Paper›PMID 30030554›Full record

ReviewDiabetologia2018

Neurodegeneration in diabetic retinopathy: does it really matter?

Rafael Simó, Alan W Stitt, Thomas W Gardner

Open access · hybridAbstract readReview
In one paragraph

Review in Diabetologia, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 356 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
356citing papers in PubMed, 1 pooled it
43.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

356 citing papers in PubMed, 1 synthesis or guideline pooled it, 549 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Review
  4. Systemic Diseases and the Eye: A Translational Perspective on Diabetes.Chronic diseases and translational medicine · 2026
    Review
  5. Interferon-mediated regulation of the neurovascular unit in diabetic retinopathy.Inflammation research : official journal of the European Histamine Research Society ... [et al.] · 2026
    Review
  6. Individualized FAZ morphometry and standardized peri-FAZ vascular density: a pilot AngioVue OCTA study in diabetic retinopathy.Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie · 2026
    Article
  7. Review
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  10. Article
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  12. Article
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  14. Article
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  16. Article
  17. Neuroprotection in Early Diabetic Retinal Disease Using Eyedrop Delivery.International journal of molecular sciences · 2026
    Review
  18. Article
  19. Article
  20. Article

296 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 3 countries.

Rafael SimóDiabetes and Metabolism Research Unit, Vall d'Hebron Research Institute, Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Instituto de Salud Carlos III (ISCIII), Universitat Autònoma de Barcelona, Pg. Vall d'Hebron 119-129, 08035, Barcelona, Spain. rafael.simo@vhir.org.
Alan W StittCentre for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, UK.
Thomas W GardnerDepartment of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan Medical School, Ann Arbor, MI, USA.
Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas · ESQueen's University Belfast · GBUniversity of Michigan–Ann Arbor · US

Funding

Regional Pilot And Feasibility Study Grants ProgramP30DK020572 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI DAVID P OLSON · 2013 to 2026
$24.3M
Integrated Systems Biology Approach to Diabetic Microvascular ComplicationsR24DK082841 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI ABCOUWER, STEVEN F, BROSIUS, FRANK C · 2008 to 2020
$13.1M
Research BaseP30DK092926 · NIDDK · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MARY ELLEN MICHELE HEISLER, ADESUWA B OLOMU · 2011 to 2026
$10.0M
Regulation of Retinal Cell Death in DiabetesR01EY020582 · NEI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI ABCOUWER, STEVEN F, GARDNER, THOMAS W. · 2010 to 2018
$4.0M
NEI NIH HHS R01 EY020582NIDDK NIH HHS P30 DK020572NIDDK NIH HHS P30 DK092926NIDDK NIH HHS R24 DK082841
6 · The paper itself

Abstract

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.

Indexed as

AnimalsBasement MembraneBlood-Retinal BarrierBlood VesselsDementiaDiabetic RetinopathyEndothelial CellsHumansMicrocirculationNeurodegenerative DiseasesNeuroprotectionNeuroprotective AgentsPrecision MedicineRetinaRetinal VesselsTomography, Optical CoherenceNeuroprotective AgentsDiabetic retinopathyMicrovascular impairmentNeurodegenerationNeuroprotectionNeurovascular unitPersonalised medicineReview

Identifiers

PMID30030554
PMCPMC6096638
OpenAlexW2794677028

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.