Pharmacotherapy for diabetic retinopathy.
BACKGROUND
Diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) continue to cause significant visual loss among patients with diabetes mellitus. In some patients unresponsive to standard laser techniques, as well as improved control of blood pressure and blood sugar, pharmacologic treatment may be beneficial. Although no agent is now approved by the FDA for this purpose, many agents are now being studied in randomized clinical trials (RCTs).


OBJECTIVE
To review concisely the chief pharmacotherapies for diabetic retinopathy available at present.


METHODS
Literature review and synopsis.


RESULTS
Used alone, intravitreal triamcinolone acetonide (IVTA) seems to have some short-term efficacy against DME, but longer-term outcomes (< or = 3 years) using IVTA monotherapy showed a lesser benefit than focal/grid laser treatment in a prospective RCT done by the Diabetic Retinopathy Clinical Research Network. Intravitreal anti-VEGF agents have demonstrated some short-term efficacy against DME, and continuing RCTs will evaluate combination therapies (anti-VEGF and laser) for both DME and PDR. Other agents are being evaluated in pilot studies and Phase II RCTs.


CONCLUSIONS
Pharmacotherapies for DME and PDR have potential for vision stabilization or improvement. Continuing RCTs will provide evidence-based data on their role in clinical practice. A potential role for pharmacotherapy in the prevention of DME and PDR is also emerging.
Schwartz
Stephen G
SG
University of Miami Miller School of Medicine, Bascom Palmer Eye Institute, 311 9th Street North, #100, Naples, FL 34102, USA. sschwartz2@med.miami.edu
Flynn
Harry W
HW
Scott
Ingrid U
IU
D003930:Diabetic Retinopathy / Q000188:drug therapy*; D004333:Drug Administration Routes; D006801:Humans; D009883:Ophthalmic Solutions
D009883:Ophthalmic Solutions