Research progress in the treatment of diabetic retinopathy_Chinese Journal of Ocular Fundus Diseases

Authors：

Xue Chen , Xu Manhong ,  Li Xiaorong

Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin Branch of National Clinical Research Center for Ocular Disease, Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin 300384, China;

Corresponding author：

Li Xiaorong, Email: lixiaorong@tmu.edu.cn

Keywords：

Diabetic retinopathy; Drug delivery; Nano materials; Gene therapy; Review

DOI：

10.3760/cma.j.cn511434-20240923-00355

Video：

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Abstract Full text Figures/Tables Video References Cited by

Diabetic retinopathy (DR) is one of the most common microvascular complications of diabetes, which seriously threatens the vision of patients. The pathogenesis of DR is complex, and the main treatment methods for DR Include: panretinal laser photocoagulation therapy, pars plana vitrectomy and intravitreal injection of drugs, etc. However, all the treatment methods have certain limitations. In recent years, progress has been made in the fields of intravitreal injection of anti-vascular endothelial growth factor drugs, anti-inflammatory therapy, anti-oxidative stress injury drugs, neuroprotective drugs, gene therapy and stem cell therapy. DR treatment drugs are loaded with nanoparticles, hydrogels and photosensitive materials, which can be continuously and efficiently released in the eye, extending the time interval of administration. In the future, personalized and precise treatment based on biomarker detection can develop more accurate treatment plans for patients and improve curative effect.

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4. Eelen G, Treps L, Li X, et al. Basic and therapeutic aspects of angiogenesis updated[J]. Circ Res, 2020, 127(2): 310-329. DOI: 10.1161/CIRCRESAHA.120.316851.
5. Inan S, Polat O, Yıgıt S, et al. PASCAL laser platform produces less pain responses compared to conventional laser system during the panretinal photocoagulation: a randomized clinical trial[J]. Afr Health Sci, 2018, 18(4): 1010-1017. DOI: 10.4314/ahs.v18i4.22.
6. Lin Z, Deng A, Hou N, et al. Advances in targeted retinal photocoagulation in the treatment of diabetic retinopathy[J/OL]. Front Endocrinol (Lausanne), 2023, 14: 1108394[2023-03-02]. https://pubmed.ncbi.nlm.nih.gov/36936172/. DOI: 10.3389/fendo.2023.1108394.
7. 袁静, 蒋爱民, 徐庆. 不同波长阈下微脉冲激光在糖尿病视网膜病变治疗中的应用比较[J]. 中国激光医学杂志, 2023, 32(5): 272-277. DOI: 10.13480/j.issn1003-9430.2023.0272.Yuan J, Jiang AM, Xu Q. Comparison of subthreshold micropulse laser of different wavelength in treatment of diabetic retinopathy[J]. Chin J Laser Med Surg, 2023, 32(5): 272-277. DOI: 10.13480/j.issn1003-9430.2023.0272.
8. Lai K, Zhao H, Zhou L, et al. Subthreshold pan-retinal photocoagulation using endpoint management algorithm for severe nonproliferative diabetic retinopathy: a paired controlled pilot prospective study[J]. Ophthalmic Res, 2021, 64(4): 648-655. DOI: 10.1159/000512296.
9. Paulus YM, Qin Y, Yu Y, et al. Photo-mediated ultrasound therapy to treat retinal neovascularization[J]. Annu Int Conf IEEE Eng Med Biol Soc, 2020, 2020: 5244-5247. DOI: 10.1109/EMBC44109.2020.9175882.
10. Pan QT, Gao ZQ, Chen XH, et al. Outcomes of a novel bubble ultra-wide field viewing system for vitreoretinal surgery[J/OL]. Acta Ophthalmol, 2022, 100(4): e1024-e1030[2021-08-17]. https://pubmed.ncbi.nlm.nih.gov/34403213/. DOI: 10.1111/aos.15006.
11. Tieger MG, Rodriguez M, Wang JC, et al. Impact of contact versus non-contact wide-angle viewing systems on outcomes of primary retinal detachment repair (PRO study report number 5)[J]. Br J Ophthalmol, 2021, 105(3): 410-413. DOI: 10.1136/bjophthalmol-2020-315948.
12. Utine CA, Kaya M, Kasal K. Wide-field vitreoretinal surgery in eyes with Boston type 1 keratoprosthesis[J]. Int Ophthalmol, 2022, 42(3): 997-1005. DOI: 10.1007/s10792-021-02083-7.
13. Arthur D, Kannan NB, Sen S, et al. Digitally assisted vitreoretinal surgery: a unique surgical teaching tool for beginners[J]. Indian J Ophthalmol, 2022, 70(2): 477-481. DOI: 10.4103/ijo.IJO_914_21.
14. Mura M, Martin W, Williams KK, et al. Comparison of 3D digitally assisted visualization system with current standard visualization for the removal of vitreous in a preclinical model[J]. Clin Ophthalmol, 2021, 15: 4499-4505. DOI: 10.2147/OPTH.S327570.
15. Nishitsuka K, Nishi K, Yamashita H. Effectiveness of intraoperative optical coherence tomography on vitrectomy for proliferative diabetic retinopathy[J]. Jpn J Ophthalmol, 2022, 66(6): 527-533. DOI: 10.1007/s10384-022-00944-x.
16. Yee P, Sevgi DD, Abraham J, et al. iOCT-assisted macular hole surgery: outcomes and utility from the DISCOVER study[J]. Br J Ophthalmol, 2021, 105(3): 403-409. DOI: 10.1136/bjophthalmol-2020-316045.
17. Confalonieri F, Barone G, Ferraro V, et al. Early versus late pars plana vitrectomy in vitreous hemorrhage: a systematic review[J/OL]. J Clin Med, 2023, 12(20): 6652[2023-10-20]. https://pubmed.ncbi.nlm.nih.gov/37892789/. DOI: 10.3390/jcm12206652.
18. Dervenis P, Dervenis N, Smith JM, et al. Anti-vascular endothelial growth factors in combination with vitrectomy for complications of proliferative diabetic retinopathy[J/OL]. Cochrane Database Syst Rev, 2023, 5(5): CD008214[2023-05-31]. https://pubmed.ncbi.nlm.nih.gov/37260074/. DOI: 10.1002/14651858.CD008214.pub4.
19. Zheng W, Chen S, Ding X, et al. Microinvasive pars plana vitrectomy versus panretinal photocoagulation in the treatment of severe non-proliferative diabetic retinopathy (the VIP study): study protocol for a randomised controlled trial[J/OL]. BMJ Open, 2021, 11(2): e043371[2021-02-22]. https://pubmed.ncbi.nlm.nih.gov/33619191/. DOI: 10.1136/bmjopen-2020-043371.
20. Bohley M, Dillinger AE, Braunger BM, et al. Intravenous injection of cyclosporin A loaded lipid nanocapsules fights inflammation and immune system activation in a mouse model of diabetic retinopathy[J]. Drug Deliv Transl Res, 2023, 13(11): 2807-2818. DOI: 10.1007/s13346-023-01350-7.
21. Sharma DS, Wadhwa S, Gulati M, et al. Chitosan modified 5-fluorouracil nanostructured lipid carriers for treatment of diabetic retinopathy in rats: a new dimension to an anticancer drug[J]. Int J Biol Macromol, 2023, 224: 810-830. DOI: 10.1016/j.ijbiomac.2022.10.168.
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