Figure 3.

Pathogenic role of persistent ER stress in diabetic retinopathy. Chronic hyperglycemia, altered energy and metabolic hemostasis, and other detrimental factors such as oxidative stress result in ER stress in retinal cells during diabetes. While temporary and mild ER stress can be overcome by the adaptive UPR, persistent ER stress activate proinflammatory and proapoptotic signaling pathways leading to apoptosis, inflammation, increased VEGF production, and ultimately BRB breakdown, retinal NV and neuronal degeneration.