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Sofija Davidovic, Slobodanka Latinovic; Systemic erythropoietin and its role in diabetic retinopathy. Invest. Ophthalmol. Vis. Sci. 2013;54(15):4616.
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© ARVO (1962-2015); The Authors (2016-present)
Apart from factors locally produced in the eye, latest research data reveal possible influence of systemic, circulatory factors on DR pathogenesis as well. Erythropoietin (EPO) is one of systemic angiogenic factors, whose role in ocular angiogenesis is still not precisely understood. The aim of this study was to analyze concentration of EPO in the blood of diabetics with DR, to evaluate does it significantly change comparing to healthy subjects, and to examine possible correlation of clinical stage of DR with change of EPO level in the blood.
The study comprised of group of diabetic patients with duration of DM ≥10 years and DR (30 nonproliferative (NPDR), 30 proliferative (PDR)), and of control group (30 healthy individuals without DM), both without any other eye or systemic disease. Concentration of EPO was assessed by ELISA method from blood samples harvested by unique pattern, and analyzed altogether in the same assay at the end of the study.
The highest average concentration of EPO in serum (9.95 mIU/ml) is determined in group of diabetics with PDR. The lowest average concentration of EPO in serum (6.90 mIU/ml) is found in control group. EPO concentration in serum is significantly higher in subgroups of moderate and severe PDR comparing to controls, NPDR and mild PDR (h=9.858, p=0.007). Multiregression analysis showed that increase of EPO concentration in the blood for 1 mIU/ml, increases probability of proliferative stage of the disease in patient with DR for 11.8%.
Significantly elevated serum concentration of EPO in advanced stages of DR, and positive correlation between EPO serum concentration and clinical stadium of PDR found in our study, suggest that erythropoietin presents one of the growth factors which in combination with other growth factors plays role in complex processes of retinal ischemia and angiogenesis in diabetic retinopathy, especially in the proliferative stage of this disease.
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