Advancements in diabetic retinopathy: Insights and future directions

Table 1 Comparative analysis of novel and traditional treatment modalities for diabetic retinopathy

Treatment modality	Description	Advantages	Limitations	Ref.
Anti-vascular endothelial growth factor (VEGF) agents	Inhibits VEGF to reduce neovascularization and vascular permeability	Effective in reducing retinal edema and preventing vision loss	High cost; requires frequent intravitreal injections; long-term safety not fully established	Morya et al[1], 2024; Wu et al[2], 2024; and Hartnett et al[10], 2024
Corticosteroids	Reduces inflammation and vascular leakage. Includes dexamethasone implants and intravitreal triamcinolone	Potent anti-inflammatory effects; effective in reducing retinal edema	Risk of cataract formation and increased intraocular pressure; requires careful patient selection and monitoring	Shiraki et al[11], 2024; and Li et al[5], 2024
Gene therapies	Corrects genetic defects or modulates gene expression to prevent/reverse retinal damage	Potential for long-lasting solutions; fewer side effects compared to traditional therapies	Experimental stages; high cost; accessibility issues; long-term effects unknown	Wu et al[2]; and Zhou et al[3], 2024
Nanotechnology-based drug delivery	Utilizes nanoparticles for efficient drug delivery and sustained-release formulations	Improved bioavailability and duration of therapeutic agents; reduces frequency of injections	Still under research; long-term safety and efficacy data needed	Wu et al[2], 2024
Traditional laser therapy	Uses laser photocoagulation to prevent neovascularization	Long-standing treatment; can prevent severe vision loss	Can cause peripheral vision loss and other complications; less effective in advanced stages	Morya et al[1], 2024
Vitrectomy	Surgical removal of vitreous gel to manage severe cases	Effective in clearing vitreous hemorrhage and relieving traction on the retina	Invasive procedure; risks include retinal detachment and infection	Morya et al[1], 2024; and Shiraki et al[11], 2024
Oral medications (e.g., Fenofibrate)	Used to manage dyslipidemia and inflammation associated with diabetic retinopathy	Convenient; can reduce the progression of diabetic retinopathy in some patients.	Variable effectiveness; side effects may include liver dysfunction and muscle pain	Morya et al[1], 2024

This table offers a comprehensive comparison of treatment options for diabetic retinopathy, contrasting novel therapies with traditional methods. Anti-vascular endothelial growth factor agents, such as ranibizumab and aflibercept, work by inhibiting vascular endothelial growth factor, which reduces neovascularization and vascular permeability. While these agents are highly effective at reducing retinal edema and preventing vision loss, they are costly and require frequent injections[1,2,10]. Corticosteroids, including dexamethasone implants and intravitreal triamcinolone, help reduce inflammation and vascular leakage. However, they carry risks such as cataract formation and increased intraocular pressure, necessitating careful patient selection and monitoring[5,11]. Emerging gene therapies offer a cutting-edge approach by targeting genetic defects or modulating gene expression, potentially providing long-lasting solutions with fewer side effects. Despite their promise, these therapies are still in experimental stages, are expensive, and have unknown long-term safety profiles[2,3]. Nanotechnology-based drug delivery systems utilize nanoparticles and sustained-release formulations to enhance drug bioavailability and extend therapeutic duration. Although these innovations improve the efficiency of drug delivery, further research is required to validate their long-term efficacy and safety[2]. Traditional laser therapy, through laser photocoagulation, remains a common method to prevent neovascularization. While effective at preventing severe vision loss, it may lead to complications like peripheral vision loss, especially in advanced stages of diabetic retinopathy[1]. Vitrectomy, a surgical intervention to remove the vitreous gel, is beneficial in managing severe cases by addressing vitreous hemorrhage and relieving retinal traction. However, this invasive procedure carries risks such as retinal detachment and infection[1,11]. Oral medications, like fenofibrate, are used to address dyslipidemia and inflammation linked to diabetic retinopathy. These medications are convenient and can slow disease progression in some patients, though their effectiveness varies, and they may come with side effects[1].