New Developments in the Drug Therapy of Diabtic Retinopathy
Lang G. E.
University Eye Hospital Ulm
Purpose: In industrialzed countries diabetic retinopathy still is the leading cause of blindness in adults despite the improvement of the prognosis by laser treatment and vitreoretinal surgery. Up to now no drug therapy is available.
Method: Current systemic drug therapy aims at slowing the progression of diabetic retinopathy and treating diabetic macular edema. Two therapeutic approaches are now investigated in phase II/III trials. One is the therapy of diabetic retinopathy with a protein kinase C inhibitor. The other is the treatment of advanced stages of diabetic retinopathy with the somatostatin analogue octreotide.
Results: Protein kinase C (PKC) is a family of intracellular regulating enzymes. PKC is activated by increased levels of blood glucose. Mediated by vascular endothelial growth factor it leads to increased vascluar permeablity and cell proliferation. The development of a selective PKC b inhibitor enables a new therapeutic approach to diabetic macluar edema and diabetic retinopathy. In phase II/III trials the effect of a specific PKC b inhibitor on diabetic retinopathy and diabetic macular edma is investigated. In the development of diabetic retinopathy growth hormon (GH) and insulin-like growth factor 1 (IGF-1) also play an important role. Octreotide is able to control the overexpression of GH and IGF-1. In pilot studies the therapuetic effect of octreotide on diabetic retinopathy is already proven. In
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