Protective treatments and their target retinal ganglion cells in diabetic retinopathy

Diabetic retinopathy(DR)is one of the complications of diabetes which could cause severe vision loss. Retinal ganglion cell(RGC)injury has been confirmed prior to micro-vascular damage. Over the past few decades, a number of animal and clinical studies have confirmed that RGC impairment leads to an early deterioration of vision in DR. Inhibition of aldose reductase (AR), advanced glycation end product (AGE), oxidative stress, glutamate toxicity, and an inflammatory response may play important roles in protecting RGCs in DR. Furthermore, nicotinamide mononucleotide adenylyl transferase-1 (Nmnat1), neurotrophins and neurotrophic factors may become new therapeutic targets. Photobiomodulation (PBM) may be used as adjunctive therapy in protective treatment of RGCs. In this review, we highlight and discuss protective treatments and their targets which have shown great promise for treatment of RGC injury in DR.