Caroline J. Magri1 and Stephen Fava
Diabetic retinopathy is a serious complication of diabetes mellitus that could potentially lead to blindness. There is growing interest in the association between this important microvascular complication and cardiovascular morbidity and mortality. In this review article, the authors analyse the currently available data that link diabetic retinopathy with cardiovascular events in both type 1 and type 2 diabetic patients, including its association with coronary heart disease, heart failure, cerebrovascular disease and cardiac autonomic neuropathy. Important retinal signs that suggest underlying cardiovascular disease are discussed together with possible underlying pathophysiological mechanisms. The clinical implications involved are considered together with future studies. The latter should address not only possible pathological mechanisms, including genetic contribution, but also the implementation of diabetic retinopathy assessment as a risk stratification tool as well as novel therapeutic agents that might be beneficial both in the management of diabetic retinopathy and cardiovascular disease in general.