Abstract
Proliferative diabetic retinopathy (PDR) is a neurovascular disease of the retina that causes severe vision loss in working adults worldwide. Hyperglycemia-induced dysregulated metabolic process activates neuro-vascular cells releasing numerous locally acting factors, particularly cytokines, into the vitreoretinal interface or vitreous body. In the pathological setting, vitreous forms an overwhelming “reservoir” by engaging an elevated level of various angiogenic and inflammatory mediators. Furthermore, an increase in the systemic level of angio-inflammatory factors in diabetic vitreous creates a depot of pathological signaling pathways by activating secondary mediators and transcriptional factors that propagate PDR pathogenesis. This chapter aims to discuss the relevance of the impaired vitreous microenvironment in sustaining and accelerating the pathogenesis of PDR. Additionally, we will discuss the PDR-vitreous fluid as helpful material for studying the patho-clinical events in the diabetic retina and obtaining pre-clinical, experimental evidence for developing new therapeutic drug candidates for PDR therapy.