Role of glucose metabolism in ocular angiogenesis

Glucose metabolism, the major source of energy, plays a crucial role in physiological cell function and the maintenance of homeostasis. Glucose acts as the predominant source of metabolic fuel in the generation of ATP and is involved in biosynthesis and epigenetics. Thus, glucose metabolism maintains a key role in cell function, homeostasis, energy generation, biosynthesis and epigenetics. An increasing number of studies have revealed that glucose metabolism is intricately involved in angiogenesis, with the disruption of angiogenesis contributing to several vascular diseases. Ocular vascular diseases are common ophthalmological disorders, and the prevalence of these disorders is increasing annually. Ocular vascular diseases largely occur from abnormal congenital development or acquired disturbances to the vasculature. Thus, identifying the process of occurrence and development of physiological and pathological angiogenesis is of utmost importance, and this involves understanding the inseparable role of intercellular communications between vascular cells. Although vascular endothelial growth factor (VEGF) is a well-recognized therapeutic target for the management of ocular vascular diseases, VEGF-based therapy fails to achieve the desired therapeutic effects in several cases, partly due to drug resistance and non-compliance. In the present review, current knowledge on the processes and roles of glucose metabolism in governing both physiological and pathological ocular angiogenesis are summarized, highlighting vascular glucose metabolism as a promising strategy for maintaining or restoring the physiological functions of the vasculature, thus potentially ameliorating ocular vascular diseases.