Rosiglitazone may preserve vision in diabetic retinopathy

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Rosiglitazone may preserve vision in diabetic retinopathy
June 12, 2008
OneTouch Diabete News-Professionals

NEW YORK (Reuters Health) - Rosiglitazone (Avandia, GlaxoSmithKline) may slow the progression of diabetic retinopathy and preserve vision by reducing retinal neovascularization, physicians at Harvard Medical School in Boston report in the June Archives of Ophthalmology.

Dr. Lloyd Paul Aiello and his associates note that rosiglitazone may be anti-angiogenic as well as an insulin sensitizer. The researchers conducted a longitudinal medical record review of 124 patients who had initiated treatment with rosiglitazone and 158 matched control patients not taking a glitazone drug. Fourteen eyes in the rosiglitazone group and 24 eyes in the control group had severe non-proliferative diabetic retinopathy at baseline.

During 3 years of follow-up, progression to proliferative diabetic retinopathy was documented in 19.2% of affected eyes in the rosiglitazone group and 47.4% in the control group, a 59% relative risk reduction.

Fewer eyes in the rosiglitazone group experienced a loss of 3 or more lines of visual acuity, in each group as a whole (0.5% vs 14.5%, p = 0.03), or in patients with severe non-proliferative diabetic retinopathy at baseline (7.1% vs 41.8%, a nonsignificant difference).

Because of the recent controversy over potential cardiovascular risk, Dr. Aiello and colleagues do not recommend rosiglitazone for patients with severe non-proliferative diabetic retinopathy until further research clearly defines its risk-benefit profile and the role of intensive glycemic therapy in type 2 diabetes.

"However," they note, "the potential benefit of rosiglitazone in reducing retinopathy progression and maintaining visual acuity could significantly reduce personal and societal burdens and should be considered if risks can be appropriately managed."

They also suggest that "rosiglitazone may benefit other pathologic angiogenic conditions such as age-related macular degeneration and certain types of cancer."

Arch Ophthalmol 2008;126:793-799.