Diabetic Retinopathy Medication

Updated: Apr 19, 2017
  • Author: Abdhish R Bhavsar, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP  more...
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Medication

Medication Summary

Several medications are indicated for treatment of diabetic retinopathy. At present, these medications are administered into the eye by intravitreal injection.

Intravitreal triamcinolone is being used in the treatment of diabetic retinopathy and diabetic macular edema. A recent Diabetic Retinopathy Clinical Research Network (DRCR.net) clinical trial demonstrated that although some reduction in macular edema occurred after intravitreal triamcinolone, this effect was not as robust as that achieved with focal laser treatment at the primary endpoint of 2 years. [15] In addition, intravitreal triamcinolone can have some adverse effects, including steroid response with intraocular pressure increase and cataracts.

Other medications used in clinical practice and in clinical trials include intravitreal aflibercept (Eylea) and ranibizumab (Lucentis). These medications are VEGF antibodies and antibody fragments, respectively. They can help reduce diabetic macular edema and neovascularization of the disc or retina. Combinations of some of these medications with focal laser treatment have been investigated in the DRCR.net clinical trials and have proven efficacy, as described above.

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Corticosteroids

Class Summary

Corticosteroids inhibit inflammatory responses. They inhibit processes associated with inflammation such as edema, fibrin deposition, capillary dilation, deposition of collagen, leukocyte migration, and fibroblast and capillary proliferation.

Triamcinolone acetonide (Triesence)

Triamcinolone is a synthetic corticosteroid with anti-inflammatory effects. It is indicated for several ophthalmic diseases such as ocular inflammatory conditions and visualization during vitrectomy. Intravitreal triamcinolone is also being used in the treatment of diabetic macular edema.

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Ophthalmics, VEGF Inhibitors

Class Summary

These agents can help reduce diabetic macular edema and neovascularization of the disc or retina.

Ranibizumab (Lucentis)

Ranibizumab is a recombinant humanized monoclonal antibody indicated for all forms of diabetic retinopathy (ie, with or without diabetic macular edema). It is also indicated for neovascular (wet) age-related macular degeneration (AMD), macular edema following retinal vein occlusion, myopic choroidal neovascularization, and diabetic macular edema. It prevents the interaction of VEGF-A with its receptors (VEGFR1 and VEGFR2), thereby suppressing neovascularization, endothelial cell proliferation, and vascular leakage.

Aflibercept intravitreal (Eylea)

Aflibercept is a recombinant decoy VEGF receptor that competes for ligand binding with the endogenous VEGFR 1 and 2 receptors to prevent angiogenesis. It is indicated for diabetic retinopathy in individuals who have diabetic macular edema. It is currently indicated for neovascular (wet) age-related macular degeneration (AMD), macular edema, and diabetic macular edema.

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