Recent Advancements in the Medical Treatment of Diabetic Retinal Disease

Int J Mol Sci. 2021 Aug 31;22(17):9441. doi: 10.3390/ijms22179441.

Abstract

Diabetic retinal disease remains one of the most common complications of diabetes mellitus (DM) and a leading cause of preventable blindness. The mainstay of management involves glycemic control, intravitreal, and laser therapy. However, intravitreal therapy commonly requires frequent hospital visits and some patients fail to achieve a significant improvement in vision. Novel and long-acting therapies targeting a range of pathways are warranted, while evidence to support optimal combinations of treatments is currently insufficient. Improved understanding of the molecular pathways involved in pathogenesis is driving the development of therapeutic agents not only targeting visible microvascular disease and metabolic derangements, but also inflammation and accelerated retinal neurodegeneration. This review summarizes the current and emerging treatments of diabetic retinal diseases and provides an insight into the future of managing this important condition.

Keywords: angiogenesis; anti-VEGF; corticosteroids; diabetic macular edema; diabetic retinopathy; glycemic control; inflammation; islet cell transplantation; pancreatic transplantation.

Publication types

  • Review

MeSH terms

  • Angiogenesis Inhibitors / therapeutic use
  • Diabetes Complications / drug therapy
  • Diabetes Complications / therapy*
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / physiopathology
  • Diabetic Retinopathy / drug therapy
  • Diabetic Retinopathy / therapy*
  • Glucocorticoids / therapeutic use
  • Glycemic Control / trends
  • Humans
  • Inflammation / drug therapy
  • Intravitreal Injections
  • Macular Edema / therapy
  • Retina / physiopathology
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors

Substances

  • Angiogenesis Inhibitors
  • Glucocorticoids
  • Vascular Endothelial Growth Factor A