title: Current and investigational drugs for the treatment of diabetic retinopathy.
abstract: BACKGROUND
  Diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR) are the two complications of diabetes that cause visual loss and blindness. Laser photo-coagulation in the past was used to prevent progression of disease to these advanced stages. Advances in pathophysiologic understanding of DME and PDR have ushered the development of effective targeted therapy that given intravitreally improves vision and prevents blindness. While effective, these therapies require frequent administration and are not universally effective.
  
  
  METHODS
  This purpose of this paper is to review the current pathophysiologic understanding and treatments for DME and PDR as well as the novel treatments currently being developed. The treatments will be juxtaposed to the factor in the disease cascade being targeted. The potential role of these novel treatment in the clinical armamentarium are postulated.
  
  
  CONCLUSIONS
  Mono-therapy, single category targeting is the current strategy being utilized clinically. However, diabetic retinopathy needs combination therapy. Therapies that will prove successful will address multiple factors involved in the pathogenesis of diabetic retinopathy.
authors.affiliation: a Department of Research , Center for Retina and Macular Disease , Winter Haven , FL , USA.
authors.forename: Michael Steven
authors.initials: MS
authors.lastname: Tolentino
authors.affiliation: a Department of Research , Center for Retina and Macular Disease , Winter Haven , FL , USA.
authors.forename: Andrew John
authors.initials: AJ
authors.lastname: Tolentino
authors.affiliation: a Department of Research , Center for Retina and Macular Disease , Winter Haven , FL , USA.|b Department of Ophthalmology , Univerisity of Central Florida , Orlando , FL , USA.
authors.forename: Michael John
authors.initials: MJ
authors.lastname: Tolentino
mesh_terms: D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D003930:Diabetic Retinopathy / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism / Q000473:pathology; D004359:Drug Therapy, Combination; D015507:Drugs, Investigational / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008269:Macular Edema / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism / Q000473:pathology; D018384:Oxidative Stress / Q000187:drug effects; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors*
chemical_list: D020533:Angiogenesis Inhibitors; D015507:Drugs, Investigational; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A
keywords: Diabetes; VEGF; diabetic retinopathy; drug development; integrins; macular edema; retinal neovascularization