Eye Disorders in Diabetes: Potential Drug Targets
| Autor: | W. Schrader, P. B. Henrich, U. Schneider, Tatjana Josifova |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Eye Diseases genetic structures Pegaptanib Basic fibroblast growth factor Vascular permeability Diabetes Complications chemistry.chemical_compound Drug Delivery Systems Risk Factors Internal medicine Ophthalmology Humans Medicine Macular edema Pharmacology Clinical Trials as Topic Diabetic Retinopathy business.industry General Medicine medicine.disease eye diseases Vascular endothelial growth factor Endocrinology chemistry Molecular Medicine Eye disorder sense organs Ranibizumab business medicine.drug Retinopathy |
| Zdroj: | Infectious Disorders - Drug Targets. 8:70-75 |
| ISSN: | 1871-5265 |
| Popis: | Diabetes Mellitus (DM) is a serious medical problem that causes long-term systemic complications and considerable associated morbidity. DM can cause retinopathy (DRP), maculopathy, cataract, optic neuropathy, defects of eye muscles. DM is a risk factor for acute infectious conjunctivitis, bacterial keratitis, herpes virus infections and endophtalmitis. Elevated blood glucose induces structural, physiological and hormonal changes which affect retinal capillaries. DRP is recognized by loss of pericyte function and capillary occlusions together leading to breakdown of blood-retinal barrier, edematous changes and proliferation of vessels and fibrous tissue. Depending on stage of DRP, there are different preferable therapeutic approaches applied. In the case of ETDRS, in the area of leakage focal treatment should be performed, while panretinal photocoagulation is applied towards ischemic areas or beginning proliferations. Vitreal haemorrhage followed by fibroproliferative changes or tractional retinal detachment is treated by vitrectomy alone or in combination with ILM peeling. In pathogenesis of DRP, Insulin Growth Factor (IGF-1) can play an important role in production of VEGF (Vascular Endothelial Growth Factor). Hypoxia can up-regulate VEGF expression levels leading to pathologic ocular neovascularisation. An application of intravitreal corticosteroid treatment modulates vascular permeability by suppressing the production of VEGF, reducing both extracellular matrix metalloproteinase activity and basic fibroblast growth factor, decreasing major histocompatibility complex 2 Ag expression levels, and inhibiting activity of inflammatory cells. Clinical effects of treatment using intravitreal corticosteroids are evaluated by reduction of macular thickness and visual improvement. Intravitreal use of Anti-VEGF drugs, Pegaptanib, Ranibizumab and Bevacizumab can modify vasoproliferation, trigger macular edema, and, therefore, influence a prognosis for visual loss. |
| Databáze: | OpenAIRE |
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