Em. Vingolo et al., Treatment of nonproliferative diabetic retinopathy with Defibrotide in noninsulin-dependent diabetes mellitus: A pilot study, ACT OPHTH S, 77(3), 1999, pp. 315-320
Purpose. Microvascular alterations, impairment of coagulation, ischemia and
diffuse endothelial damage are related to the progression of diabetic reti
nopathy, Defibrotide has been demonstrated to produce profibrinolytic, cyto
protective and vasofacilatory activities. The aim of the present study was
to evaluate the therapeutic effect of Defibrotide in the treatment of nonpr
oliferative diabetic retinopathy,
Methods, Two randomized age- and sex-matched groups (cases and controls) of
35 NIDDM patients presenting non-proliferative diabetic retinopathy were i
ncluded in this study: cases were treated with Defibrotide (800-1600 mg dai
ly) for two years.
Results, All tested parameters (ETDRS visual acuity; computerized perimetry
; retinography; fluorescein angiography), improved significantly (p<0.001)
in Defibrotide-treated patients compared to controls. In our opinion, Defib
rotide's manifold effects on vascular endothelia may account for this impro
vement by stimulation of tPA, PGI(2), PGE(2), thrombomodulin and modulation
of endothelin-1 release.
Conclusions. Our preliminary data seem to suggest that Defibrotide could be
proposed for medical treatment of nonproliferative diabetic retinopathy.