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L.Q. Shen, A. Child, D. Magoon, G. Beebe, G. Weber, J. Folkman, L.P. Aiello; Rosiglitazone May Delay Progression to Proliferative Diabetic Retinopathy . Invest. Ophthalmol. Vis. Sci. 2006;47(13):2333.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate whether rosiglitazone, an oral medication for diabetes with reported antiangiogenic properties, may delay the development of proliferative diabetic retinopathy (PDR).
A longitudinal chart–review study was initiated at the Joslin Diabetes Center (JDC) in 2003. Patients taking rosiglitazone in May, 2003 were included if they received both medical and ophthalmic care from JDC, and had at least one eye exam in the preceding year. A non–glitazone control group matched for baseline characteristics was also included in the study.
124 rosiglitazone (rsg) patients and 158 control (ctl) patients were followed for an average of 2.8 + 1.7 years. The two groups were similar (p>0.1) at baseline in age, gender, type and duration of diabetes, HbA1c, blood pressure control, and visual acuity (VA). Final HbA1c was 7.6 and 7.8 in rsg and ctl groups, respectively (p=NS). In patients with severe nonproliferative diabetic retinopathy (NPDR), progression to PDR was 14.3% (2/14 eyes) and 45.8% (11/24 eyes) in the rsg and ctl groups, respectively. When accounting for follow–up duration and loss, development of PDR in rsg group occurred at a slower rate (p=0.0448, Wilcoxon; p=0.0587, Log–Rank). PDR developed in 25% of ctl group within 1 year (95% confidence interval: 122–518 days), while rsg group had not reached this point after 2.5 years. Average final VA was 20/34 in rsg group and 20/46 in ctl. In patients with moderate NPDR, 11.1% (4/36 eyes) and 12.5% (7/56 eyes) developed PDR in rsg and ctl groups, respectively (p=NS). The rates of developing clinically significant macular edema (CSME) in patients with no edema at baseline were 6.5% (12/184 eyes) and 4.5% (10/222 eyes), respectively (p=NS).
Previous in vitro and animal studies have identified antiangiogenic activity of rosiglitazone. This preliminary, relatively short–term pilot study suggests that rosiglitazone therapy may delay ocular neovascularization in diabetic patients and supports continued evaluation of this cohort as well as more definitive future investigations.
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