The value of calcium dobesilate in the treatment of diabetic retinopathy

Abstract

The effect of calcium dobesilate on capillary resistance and background retinopathy was compared with placebo in a double-blind cross-over trial on 18 diabetics. Each treatment lasted 8 months. The trial produced no evidence in favour of a significant beneficial effect of calcium dobesilate on the capillary resistance in diabetics or on the course of the diabetic retinopathy.

Calcium Dobesilate Inhibits the Alterations in Tight Junction Proteins and Leukocyte Adhesion to Retinal Endothelial Cells Induced by Diabetes

“…For example, in a double-blind, placebo-controlled study, a positive effect of CaD (2,000 mg daily for 2 years) was shown in patients with early diabetic retinopathy (25). Other studies have reported no beneficial effects of CaD in the retina of diabetic patients (27–29). In a recent study (CALDIRET) (30), where mild-to-moderate nonproliferative diabetic retinopathy patients were followed for five years, CaD failed to reduce diabetic macular edema.…”

“…CaD decreases albumin leakage in the retina of diabetic animals (26), supporting its beneficial effects in BRB permeability. Other studies did not find beneficial effects in patients with diabetic retinopathy (27–29), but patients were treated with lower doses of CaD and for shorter periods (6–12 months). Recently, in a follow-up study (CALDIRET) of five years involving 635 patients with mild-to-moderate nonproliferative diabetic retinopathy, treatment with CaD was not able to reduce macular edema (30).…”

Calcium dobesilate for diabetic retinopathy: a systematic review and meta-analysis

“…The breakdown of the BRB is an early sign of vascular damage. Several methods have been applied to evaluate the function of BRB among RCTs and animal studies, including vitreous fluorophotometry [27], PVPR [25], vascular fragility [28], skin capillary resistance [19,23] and the penetration ratio [21]. Albumin leakage [29] indicates the successful treatment of capillary fragility in DR patients.…”

“…Study type Randomization Blinding Lost to follow up Jadadscore Larsen et al [19] RCT 1 2 1 4 Vojnikovic et al [20] RCT 1 2 1 4 Leite et al [21] RCT 2 2 1 5 Benarroch et al [22] RCT 1 2 1 4 Vojnikovic et al [23] RCT 1 2 1 4 Benarroch et al [24] RCT 1 2 0 3 Ribeiro et al [25] RCT 1 2 1 4 Javadzadeh et al [26] RCT 2 2 0 4 a) DB, double blinding; RCT, randomized clinical trial; estimated effects of calcium obesilate on study characteristics, independent comparisons only (n=8). …”

Calcium Dobesilate in Prevention and Treatment of Diabetic Retinopathy

“…Each treatment lasted 8 months. The study gave no evidence of a significant beneficial effect of calcium dobesilate on the capillary resistance in diabetics or on the course of the diabetic retinopathy (Larsen et al, 1977). The additional two independent, double-blind, controlled studies were performed to evaluate the efficacy of calcium dobesilate for the treatment of nonproliferative diabetic retinopathy.…”