Recent advances in the treatment and delivery system of diabetic retinopathy

Front Endocrinol (Lausanne). 2024 Feb 15:15:1347864. doi: 10.3389/fendo.2024.1347864. eCollection 2024.

Abstract

Diabetic retinopathy (DR) is a highly tissue-specific neurovascular complication of type 1 and type 2 diabetes mellitus and is among the leading causes of blindness worldwide. Pathophysiological changes in DR encompass neurodegeneration, inflammation, and oxidative stress. Current treatments for DR, including anti-vascular endothelial growth factor, steroids, laser photocoagulation, and vitrectomy have limitations and adverse reactions, necessitating the exploration of novel treatment strategies. This review aims to summarize the current pathophysiology, therapeutic approaches, and available drug-delivery methods for treating DR, and discuss their respective development potentials. Recent research indicates the efficacy of novel receptor inhibitors and agonists, such as aldose reductase inhibitors, angiotensin-converting enzyme inhibitors, peroxisome proliferator-activated receptor alpha agonists, and novel drugs in delaying DR. Furthermore, with continuous advancements in nanotechnology, a new form of drug delivery has been developed that can address certain limitations of clinical drug therapy, such as low solubility and poor penetration. This review serves as a theoretical foundation for future research on DR treatment. While highlighting promising therapeutic targets, it underscores the need for continuous exploration to enhance our understanding of DR pathogenesis. The limitations of current treatments and the potential for future advancements emphasize the importance of ongoing research in this field.

Keywords: anti-VEGF drugs; diabetic retinopathy; drug-delivery system; gene therapy; laser treatment; nanotechnology.

Publication types

  • Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiotensin-Converting Enzyme Inhibitors
  • Diabetes Mellitus, Type 2* / complications
  • Diabetic Retinopathy* / complications
  • Diabetic Retinopathy* / drug therapy
  • Humans
  • Inflammation / complications
  • Steroids / therapeutic use

Substances

  • Angiotensin-Converting Enzyme Inhibitors
  • Steroids

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work was supported by the Natural Science Foundation of Hubei Province [grant number 2023AFC019]; the Hubei Key Laboratories Opening Project [grant number 2021KFY055]; the Natural Science Foundation of Hubei Province [grant number 2020CFB240]; and the Fundamental Research Funds for the Central Universities [grant number 2042020kf0065].