Current Treatments in Diabetic Retinopathy

Dr. Mahmut Asfuroğlu

Ankara Bilkent City Hospital, Department of Ophthalmology, Ankara, Türkiye

ABSTRACT

Diabetic retinopathy (DR) is a unique neurovascular complication of diabetes mellitus and one of the most prevalent causes of blindness worldwide. Current treatment options for DR, including intravitreal injections of anti-vascular endothelial growth factor (VEGF) and steroids, laser photocoagulation and vitrectomy, have limitations and side effects. It is therefore necessary to develop new treatment approaches. The development of new laser systems that improve precision, reduce treatment time and cause minimal retinal damage with- out loss of efficacy compared to conventional laser systems is being undertaken. In addition, the researchers aim to increase the efficacy of the anti-VEGF treatment by finding those with longer half-lives, more potent binding to the VEGF receptor and those that act by more than one mechanism. Newer studies indicate that novel drugs such as senolytics, antioxidants, and novel receptor inhibitors and agonists such as aldose reduc- tase inhibitors, angiotensin-converting enzyme inhibitors, and peroxisome proliferator-activated receptor-al- pha-agonists are effective in halting DR. In the near future, the introduction of new nanotechnology-based drug delivery systems will make it possible to overcome various ocular anatomical and physiological barriers and deliver higher therapeutic concentrations to the targeted retinal tissue for extended periods of time with less invasive modalities. Stem cell and gene therapies are other promising areas of novel research in DR ther- apy. Stem cell therapy is being studied to promote the regenerative capacity of the retina, while gene therapy is being studied to halt the progression of retinal vasculopathy or to protect the retina. In the area of surgical treatment, the aim is to have less invasive and safer procedures through the use of smaller incisions and better imaging systems. The limitations of existing treatments and the promising potential of new developments are inspiring continued research in this area to facilitate advances in the field.

Keywords: Diabetic retinopathy; Laser treatment; Anti-VEGF drugs; Gene therapy; Nano-delivery technologies

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