2015
DOI: 10.2174/0929867322666150520095923
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Non-Traditional Systemic Treatments for Diabetic Retinopathy: An Evidence-Based Review

Abstract: Abstract:The rapid escalation in the global prevalence diabetes, with more than 30% being afflicted with diabetic retinopathy (DR), means it is likely that associated vision-threatening conditions will also rise substantially. This means that new therapeutic approaches need to be found that go beyond the current standards of diabetic care, and which are effective in the early stages of the disease. In recent decades several new pharmacological agents have been investigated for their effectiveness in preventing… Show more

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Cited by 23 publications
(15 citation statements)
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“…9 CaD has multiple mechanisms of action which include antioxidant and anti-inflammatory properties, However, to the best of our knowledge, there have been no studies examining whether CaD exerts a neuroprotective action on DR.…”
Section: Introductionmentioning
confidence: 99%
“…9 CaD has multiple mechanisms of action which include antioxidant and anti-inflammatory properties, However, to the best of our knowledge, there have been no studies examining whether CaD exerts a neuroprotective action on DR.…”
Section: Introductionmentioning
confidence: 99%
“…The microvascular degeneration is a slow process that involves apoptosis of endothelial cells and pericyte loss that lead to development of occluded (acellular) capillary formation resulting in retinal ischemia [3]. Development of clinically significant ischemia switch DR to the proliferative stage, where upregulation of pro-angiogenic factors including vascular endothelial growth factor (VEGF) resulting in retinal neovascularization and eventually blindness [4,5]. Current therapeutic options, including photocoagulation, vitrectomy, and repeated intravitreal anti-VEGF injections, are invasive and limited by considerable side effects [6].…”
Section: Introductionmentioning
confidence: 99%
“…Newer treatments that inhibit the potent vascular permeability and angiogenic mediator, VEGF, have provided a significant advance in the treatment of DR. 3 However, repeated intraocular injections are required and a substantial number of eyes are resistant to anti-VEGF treatments. 4 Therefore, there is a necessity for further investigation into more effective treatment strategies that prevent the underlying causal factors involved in the development of DR. 5 Retinal Müller cells are of interest due to the key role these macroglia have in the vascular dysfunction and inflammation that occurs in DR. 6 The processes of Müller cells are in close contact with the retinal microvasculature to maintain the integrity of the inner retinal blood-retinal barrier (BRB), 7 and damage to retinal Müller cells can result in the amplified production of VEGF, vascular leakage, and the increased production of proinflammatory mediators. [8][9][10][11] Furthermore, oxidative stress is a major causal factor in the development of vascular and glial cell pathology in DR and arises when there is an imbalance between the excess production of reactive oxygen species (ROS) and compromised antioxidant defense mechanisms.…”
mentioning
confidence: 99%