Neurovascular unit (NVU) refers to a functional complex of neural cells and vasculature, which plays an important role in maintaining retinal homeostasis and matching metabolic demands. In physiological situation, retinal NVU mainly exerts two effects: (1) maintaining blood-retinal barrier for retinal homeostasis maintenance; (2) regulating local blood flow to meet metabolic and functional demands of the retina. The pathological changes in retinal diseases are reflected in each functional part of retinal NVU, including cell-cell connections, signal pathways, metabolic activities and cellular functions. However, the main pattern and manifestation of NVU impairment differs among retinal diseases due to different etiologies. At present, understanding on retinal NVU is still insufficient, and its clinical application is even more limited. Further application in the diagnosis and treatment of retinal diseases is an important direction for future research on NVU.
ObjectiveTo review the research progress of neural regulation mechanism of vasculogenesis. MethodsThe relevant literature on neural regulation mechanism of vasculogenesis was extensively reviewed. ResultsNeural regulation of vasculogenesis depends on synergistic effect among various cells of neurovascular unit, and co-participation of multiple cytokines, and it is closely related to a variety of repair mechanism, such as nerve regeneration and synaptic plasticity, but the specific mechanism need to be further investigated. ConclusionThe research of the neural regulation mechanism of vasculogenesis will contribute to further understanding repair mechanism of nerves and vessels injuries.
Diabetes retinopathy (DR) is a blinding ocular complication of diabetes, and its pathological mechanism is complex. The damage to the retinal neurovascular unit (NVU) and the imbalance of its coupling mechanism are important pathological foundations. Autophagy plays an important role in the progression of DR. Oxidative stress, endoplasmic reticulum stress, hypoxia, and competitive endogenous RNA regulatory networks can affect the occurrence of autophagy, and autophagy induced cell death is crucial in NVU dysfunction. Retinal neurocyte are non- renewable cells, and adaptive autophagy targeting neuronal cells may provide a new direction for early vision rescue in patients with DR. It is necessary that exploring the possible autophagy interrelationships between ganglion cells, glial cells, and vascular constituent cells, searching for targeted specific cell autophagy inhibitors or activators, and exploring the impact of autophagy on the NVU complex more comprehensively at the overall level. Adopting different autophagy intervention methods at different stages of DR may be one promising research directions for future DR.
ObjectiveTo observe and evaluate the functional-structural correlations of quick contrast sensitivity function (qCSF), quantitative color vision, best-corrected visual acuity (BCVA), and peripapillary retinal nerve fiber layer (pRNFL) thickness among different stages of diabetic retinopathy (DR). MethodsA prospective cross-sectional observational study. From November 2023 to August 2025, 135 eyes of 79 patients with type 2 diabetes diagnosed at the Endocrinology Department of Lanzhou University Second Hospital were enrolled. According to the presence and severity of DR, the eyes were divided into no DR (NDR) group (53 patients, 99 eyes), non-proliferative DR (NPDR) group (18 patients, 27 eyes), and proliferative DR (PDR) group (8 patients, 9 eyes). Forty healthy volunteers (80 eyes) were selected as the control group during the same period. All subjects underwent BCVA, qCSF, color vision, and optical coherence tomography (OCT) examinations. BCVA was measured using the international standard visual acuity chart and converted to logarithm of the minimum angle of resolution (logMAR) for statistical analysis. Contrast sensitivity (CS) was measured at spatial frequencies of 3, 6, 12, and 18 cpd using a CS test instrument; the complete qCSF was plotted using Bayesian adaptive psychophysical algorithms, and the area under the log CS function (AULCSF) was exported. The average, superior, nasal, temporal, and inferior pRNFL thicknesses were measured using OCT. Binary logistic regression analysis was performed to identify risk factors affecting different stages of DR progression; receiver operating characteristic (ROC) curve analysis was used to evaluate diagnostic efficacy. ResultsSignificant differences were found among the control, NDR, NPDR, and PDR groups in logMAR BCVA (H=41.077), AULCSF (F=48.893), CS at different spatial frequencies (F=27.528, 35.194, 49.427, 39.689), color vision (H=41.165), and inferior and temporal pRNFL thicknesses (F=6.518, 3.177; P＜0.005). No significant differences were observed in superior, nasal, or average pRNFL thicknesses (F=1.828, 1.832, 0.934; P＞0.05). Multivariate binary logistic regression analysis showed that AULCSF and CS at 3 and 6 cpd were independent protective factors for DR progression (P＜0.05); color vision was an independent protective factor for DR progression (P＜0.05); BCVA was an independent risk factor for NPDR and PDR (P＜0.05), and pRNFL thickness was an independent protective factor for NPDR and PDR (P＜0.05). ROC curve analysis showed that the AUC values of AULCSF and color vision in distinguishing NDR (AUC=0.701?0.850) and NPDR (AUC=0.642?0.838) were higher than those of BCVA (AUC=0.610?0.726) and pRNFL thickness (AUC=0.501?0.560). ConclusionsDuring the progression of DR, qCSF and quantitative color vision can identify neural functional abnormalities earlier than visual acuity decline and structural damage during DR progression.