Figure 3
From: Diabetic macular edema: new concepts in patho-physiology and treatment
Hyperglycemia and its metabolic pathways. Four distinct glucose metabolic pathways are activated by hyperglycemia: Diacylglycerol (DAG)–protein kinase C (PKC), advanced glycation endproducts/ receptor for advanced glycation end-products, Polyol (sorbitol) and Hexosamine pathways. Activation of the metabolic pathways leads microvascular dysfunction, neuronal apoptosis, glial reactivity and component deposition.