The main problem for individuals suffering from Diabetic Retinopathy - damage to the retina caused by diabetes - is that this is a progressive disease that, when not monitored closely, only detected when the loss of vision is already in an advanced state. Moreover, at this stage, the vision los sis irreversibleWhen vision loss is in an advanced state, it is irreversible, since there is no cure but only therapeutics that simultaneously have serious implications for the patient.
The duration of Diabetes is the most important factor when it comes to the appearance of Diabetic Retinopathy. Which means that the metabolic control of glycemia is essential for the prevention and control of diabetic retinopathy. This disease relates to the problem of retina diabetes, that can be a non-proliferative type, which is the most common, and the proliferative type. In diabetic proliferative retinopathy, the capillaries in the back of the eye swell and form pouches, which progress from mild to moderate, from severe to advanced if not detected and treated quickly. In diabetic proliferative retinopathy the blood vessels get obstructed and are not able to carry oxygen to the retina. The main primary consequences of this disorder can either be retinal detachment or glaucoma.
The main existing treatments are intraocular administration of agents that prevent blood spreading, which has as dominant disadvantage the need for frequent administration. At a later stage of the disease, when the blood reaches very high levels, there is a surgical approach, however, its secondary effects can lead to the reduction of the amount of functional retina, reducing the quality of vision. Thus, and accordingly to Paula Macedo and Gabriela Silva, researchers at CEDOC-NMS|FCM, the existing therapies have disadvantages since they only slow the disease’s progression by treating the symptoms rather than healing them. The two researchers emphasize that next-generation therapies will aim to address the cause of the disease and not its consequences, and in that way, the mechanisms behind the development and origin of diabetic retinopathy will have to be investigated in depth. Thus, the therapies can be directed either to the initial stages of the disease or to the specificities of each patient, since the progression is not equal in all people.
The assistant professor and coordinator of Nova Medical School's Gene Therapy Laboratory for Retinopathies, Gabriela Silva, also addresses the question of how long an investigation takes - especially at a time when laboratory work seeks to prove the effectiveness of the treatments being developed - and the fact that there is often no funding, something that conditions the research. On the other hand, she adds that there are several groups in the world working on different approaches, so a new therapy will be reached in the future, although it is a very time consuming process.
Full interview here.