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TAKEN FROM KRESGE EYE INSTITUE AT DETROIT MEDICAL CENTER PREMIERE EYE PUBLICATION AUGUST 2014 The National Eye Institute predicts that almost half of all people with diabetes in the United States have some form of diabetic retinopathy. With 850,000 new cases of diabetes being diagnosed each year, the numbers continue to climb. Diabetic retinopathy is the leading cause of blindness in adults. It is a duration-dependent disease but onset and severity is influenced by how well the blood sugar is controlled and other factors such as smoking and hypertension. It is detected in the first few years of diabetes and increases to 50 percent by 10 years; 90 percent have some degree of retinopathy by 25 years of diabetes. The prevalence of diabetic retinopathy is increasing due to prolonged survival of diabetic patients. This high prevalence is spurring research at Kresge Eye Institute, including studies aimed at understanding the basic mechanisms causing diabetic retinopathy and new and better medical and surgical treatments. Renu Kowluru, Ph.D, a Professor at Wayne State University and Kresge Eye Institute, is studying the role that oxidative stress plays in damaging the capillaries, the small blood vessels of the retina, in diabetic retinopathy. Hyperglycemia (high blood sugar) leads to a series of biochemical reactions that damage these vessels causing swelling of the retina, hemorrhages and development of abnormal new blood vessels and scar tissue that cause visual loss. In animal models of diabetic retinopathy, Dr. Kowluru has demonstrated that high doses of antioxidant vitamins and minerals can prevent blood vessel damage. She hopes that by finding the mechanisms that cause the damage she will be able to target specific biochemical pathways and find a drug to prevent diabetic retinopathy. She predicts that the key lies in the mitochondrial dysfunction which leads to accelerated retinal capillary cell death. Originally trained in India, Dr. Kowluru honed her interest in diabetic retinopathy working with prominent researchers at the University of Wisconsin. She has established one of the preeminent laboratories in the world at Kresge Eye Institute. Her research is supported by the National InstWe tell patients the importance of glycemic control, but it is a case of easier said than done,” Dr. Kowluru said. “We also know the resistance to reversing retinopathy after reestablishing good glycemic control. Any period of hyperglycemia has long-term imprints that seem to result in a resistance. We are working to define the biochemical abnormalities that contribute to this metabolic memory.” Characterization of the abnormalities could reveal novel targets for therapies to prevent the progression of retinopathy, and offer patients an opportunity to supplement their best possible glycemic control with adjunct therapies.” Diabetic retinopathy is a primary area of interest for Kresge Eye Institute, and for many years its doctors have done groundbreaking research in medical, laser and surgical treatment options. Ophthalmologist Robert Frank, M.D., was one of the first in the country to show promising laser treatment results for proliferative diabetic retinopathy. KEI Director and ophthalmologist Dr. Gary Abrams developed the en bloc dissection technique for diabetic retinopathy, variants of which have become the worldwide norm for vitrectomy. Drs. Abrams and Frank, along with other retina specialists, Drs. Raymond Iezzi, Tamer Mahmoud and James Puklin have conducted more than 10 clinical studies of new drugs, laser treatments or surgeries for diabetic retinopathy in the past three years. Patients benefit from the advanced medical and surgical treatment provided to them at Kresge Eye Institute. “Our group has led in development of surgical techniques in management of diabetic retinal detachment and management of lens and corneal complications problems associated with vitrectomy,” Dr. Abrams said. “With exciting breakthroughs such as this one provided by Dr. Kowluru, we look forward to the day we will no longer simply treat diabetic retinopathy, but prevent it. We are thrilled to support Dr. Kowluru and look forward to one day testing her findings in clinical trials. Visit one of our 8 locations including Fort MyersNaples, and Cape Coral.

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