Pharmacotherapy for Treatment and Prevention of Proliferative Diabetic Retinopathy

Proliferative diabetic retinopathy poses a major public health burden with panretinal photocoagulation the only standard of care. Given the recent studies demonstrating the effectiveness of anti-vascular endothelial growth factor (VEGF) therapy for treating diabetic macular edema, pharmacotherapy may also be useful for prevention and treatment of proliferative diabetic retinopathy. Anti-VEGF therapy shows the greatest promise with its ability to delay retinopathy progression and even lead to improvements in disease severity. Furthermore, it may be useful for inducing regression of retinal and iris neovascularization. Corticosteroids, tetracyclines, and ocriplasmin are other treatments that have been considered. Additional randomized controlled trials are needed to support routine use of pharmacotherapy for specific indications in patients with proliferative diabetic retinopathy.