Current approaches in treatment of Diabetic Retinopathy
Keywords:
Diabetic retinopathy, diabetic macular edema, anti-VEGF, corticosteroids, laser therapy, pars plana vitrectomy, gene therapy, stem cells, artificial intelligence.Abstract
Diabetic retinopathy (DR) is a leading cause of vision loss in working-age adults, driven by diabetes-induced retinal microvascular damage. With global diabetes prevalence rising, effective management strategies are increasingly critical.
The aim is to provide a comprehensive overview of current and emerging therapeutic approaches for DR, highlighting pharmacologic, laser, surgical, and systemic interventions.
A literature review was conducted focusing on clinical trials, real-world studies, and recent advances in DR management. Key outcomes, safety profiles, and dosing strategies of anti-vascular endothelial growth factor (anti-VEGF) agents, corticosteroids, laser photocoagulation, and pars plana vitrectomy (PPV) were summarized. Emerging modalities including gene therapy, stem cell interventions, and artificial intelligence (AI)-assisted diagnostics were also evaluated.
Anti-VEGF therapy remains first-line for diabetic macular edema and proliferative DR, with agents such as ranibizumab, aflibercept, brolucizumab, and faricimab demonstrating significant visual and anatomical improvements. Corticosteroid implants provide alternatives for refractory cases, though they carry risks of cataract and elevated intraocular pressure. Laser photocoagulation reduces vision loss in select patients, particularly where pharmacologic access is limited. PPV achieves favorable outcomes in advanced disease with vitreoretinal complications. Emerging therapies, including gene and stem cell approaches, as well as AI-assisted screening, offer promising personalized and disease-modifying options. Comprehensive systemic control of glycemia and blood pressure enhances ocular outcomes.
DR management requires an individualized, multifaceted approach integrating established and novel therapies. Advances in pharmacology, surgical techniques, and technology have improved visual prognosis, but continued research and equitable access remain essential to address the global DR burden.
