Diabetes is a systemic disease that can, and often affects many areas of the body. The search for a cure has been long, and difficult, and to date the only therapy has been to manage the condition and treat the symptoms. While better blood glucose control has been at the apex of this therapy, it has not stemmed the secondary changes that damage collateral bodily systems. An often devastating diabetic complication is bleeding in the back of the eye, or retina. This condition is called Diabetic Retinopathy. There are several stages of this condition starting with simple dot and blot hemorrhages. This is when the blood vessels in the eye leak blood. As this continues to worsen, the bleeding gets more extensive and blood components are seen in the retina as well. This condition is called Preproliferative Diabetic Retinopathy. This stage is usually accompanied by other systemic problems concomitantly.
As the retinal condition deteriorates, the patient enters the proliferative stage (PDR) where extensive bleeding, inflammatory fluids and some retinal tissue death occur. Until recently. improved blood sugar management was always advised and retinal laser therapy was employed. It basically treated the symptoms, but not the condition. While these therapeutic approaches are still used, new potential therapy has emerged that may be far superior in preventing these devastating ocular complications.
A study recently published in the Archives of Ophthalmology described research involving Avandia which is a diabetes medication. It concluded that this drug may delay, or prevent the onset of proliferative diabetic retinopathy. This medication is an anti-angiogenic drug that slowed new vessel growth in the retina caused by the retinopathy. New vessel growth in the retina typically causes lose of vision in that area. By preventing this new, immature and unwanted blood vessel growth, the proliferative changes can be avoided and the potentially sight threatening condition may be avoided.
The three year follow up of this study demonstrated that 19.2% of the individuals progressed to progressive diabetic retinopathy, while 47.4% did not. The study further concluded that using Avandia reduced the relative risk of contracting PDR by 59.5%. While these results are very exciting, and promising to diabetics, there are other factors that may contribute to success or failure of this drug as it applies to the retinal condition. Other medical conditions, stability of the blood glucose level and insulin use are but a few of these external factors.
Further studies must be conducted before this drug can be used as a standard for diabetic retinopathy therapy, but at the very least a great starting point.
Dr. Jay B Stockman is a contributing editor for
VisionUpdate.net, and a practicing doctor for New York Vision Associates, http://newyorkvisionassociates.com,
