The increasing number of individuals with diabetes suggests that diabetic retinopathy DR is
a major contributor to vision loss. The initial disease is characterized by increased vascular
permeability due to a breakdown in the blood-retinal barrier
BRB, causing macular edema DME,
with a progressive vascular occlusion and retinal neovascularization which are secondary to
ischemia and oxidative stress. Laser photocoagulation and vitrectomy only target advanced stages
of disease. However, despite laser treatment, patients with DME experienced gradual loss of
vision. Intravitreal triamcinolone IVTA reduces the breakdown of BRB and down-regulates the
production of vascular endothelial growth factor VEGF. IVTA may moderately but temporarily
improves visual acuity in cases of DME. Agents that attenuate VEGF action such as bevacizumab
are expected to reduce permeability and neovascularization. Intravitrealbevacizumab IVB reduces
macular edema secondary to central retinal vein occlusion, vascular permeability and fibrovascular
proliferationin. Calcium dobesilate CD is a potent antioxidant, slows vascular proliferation.
