Treatment of Diabetic Retinopathy with Protein Kinase C Subtype beta Inhibitor

摘要

Despite better options of controlling diabetes mellitus and although the prognosis of diabetic retinopathy has markedly improved by laser treatment and vitreoretinal surgery, diabetic retinopathy is still the leading cause of blindness in working-age people in industrialized countries. Little has changed in the last decades concerning the prognosis of ocular complications in diabetes mellitus. Therefore, we need better tools for prevention and treatment of diabetic ocular complications due to diabetic retinopathy that go beyond reduction in glycemia, blood pressure and cholesterol levels. Newer therapeutic options are directed at the causative mechanisms of diabetic retinopathy. Experimental and clinical evidence suggests that pharmacological compounds like protein kinase C subtype beta (PKC-beta) inhibitors may be effective in the treatment of diabetic retinopathy. One important pathomechanism in the development of diabetic retinopathy is the activation of PKC induced by high glucose due to an increased diacylglycerol level. The selective PKC-beta inhibitor ruboxistaurin mesylate enables a new therapeutical approach for the treatment of diabetic retinopathy and diabetic macular edema. Ongoing prospective clinical trials investigate if treatment with the specific PKC-[3 inhibitor ruboxistaurin mesylate can prevent the progression of diabetic retinopathy and diabetic macular edema.