Lipids and diabetic retinopathy.

INTRODUCTION: Diabetic retinopathy (DR) is a significant cause of visual impairment worldwide. The association between hyperlipidemia or dyslipidemia and DR has been investigated extensively, but a conclusive link remains elusive. This review summarizes the current knowledge regarding lipids and DR. AREAS COVERED: The clinical literature on the associations between the 'traditional' lipid markers and DR will be critically evaluated, along with some of the postulated biological mechanisms underlying the associations. The emergence of several novel 'non-traditional' lipid fractions as possible biomarkers for DR will also be discussed. The review will conclude by evaluating current lipid-lowering therapies in DR and also give an overview of other novel treatments targeting lipid pathways. EXPERT OPINION: Future studies need to address three important issues. First, the role of novel lipid biomarkers needs to be clarified in light of the persistent failure of epidemiological studies to demonstrate a clear association between traditional lipids and DR. Second, the pathways by which lipid-lowering therapies act in preventing the retinal complications of diabetes need to be elucidated. Last, identifying the patient profile that would benefit most from treatment is essential.