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The effects of an aldose reductase inhibitor on the progression of diabetic retinopathy

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Abstract

The polyol pathway has long been associated with diabetic retinopathy. Glucose is converted to sorbitol with the aid of the enzyme aldose reductase. Aldose reductase inhibitors can prevent changes induced by diabetes. A total of 30 patients with minimal background retinopathy were randomly divided into a ponalrestat-taking group and a placebo-taking group. All were followed for 6 months and twenty-three were followed for 12 months. The baseline microaneurysm count was 2.6 ± 1.9 (mean ± SD) for the ponalrestat group and 3.5 ± 2.9 for the placebo group. At 6 months the counts were 3.1 ± 3.5 and 2.9 ± 3.6 and after 12 months 3.0 ± 4.1 and 2.9 ± 3.4. There is no statistically significant difference between the groups at 0, 6 or 12 months of study. The change in retinopathy severity level did not significantly differ between the two groups at either 6 or 12 months. Ponalrestat adminstration at a dosage of 600 mg daily for 12 months has no significant effect on the course of minimal retinopathy in diabetic patients.

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References

  1. Kahn HA, Moorhead HB. Statistics on blindness in the Model Reporting Area, 1969–1970. Washington DC: US Dept of Health, Education and Welfare (Public Health Service Publication NIH 73–427), 1973.

    Google Scholar 

  2. Naeser P, Brolin SE, Eriksson UJ. Sorbitol metabolism in retina studied in vitro. Graefe's Arch Clin Exp Ophthalmol 1989; 227: 180–183.

    Google Scholar 

  3. Naeser P, Brolin SE, Eriksson UJ. Sorbitol metabolism in the retina, optic nerve and sural nerve of diabetic rats treated with an aldose reductase inhibitor. Metabolism 1988; 37: 1143–1145.

    Google Scholar 

  4. Vinores SA, Campochiaro PA, Williams EH, May EE, Green WR, Sorensen RL. Aldose reductase expression in human diabetic retina and pigment epithelium. Diabetes 1988; 37: 1658–1664.

    Google Scholar 

  5. Robison WG Jr, Tillis TN, Laver N, Kinoshita JH. Diabetes-related histopathologies of the rat retina prevented with an aldose reductase inhibitor. Exp Eye Res, 1990; 50: 335–366.

    Google Scholar 

  6. Robison WG Jr, Nagata M, Laver N, Hohman TC, Kinoshita JH. Diabetic-like retinopathy in rats prevented with an aldose reductase inhibitor. Invest Ophthalmol Vis Sci 1989; 30: 2285–2292.

    Google Scholar 

  7. Robison WG Jr, Nagata M, Tillis TN, Laver N, Kinoshita JH. Aldose reductase and pericyte-endothelial cell contacts in retina and optic nerve. Invest Ophthalmol Vis Sci 1989; 30: 2293–2299.

    Google Scholar 

  8. Chakrabarti S, Sima AAF. Effect of aldose reductase inhibition and insulin treatment on retinal capillary basement membrane thickening in BB rats. Diabetes 1989; 38: 1181–1186.

    Google Scholar 

  9. Kador PF, Akagi Y, Terubayashi H, Wyman M, Kinoshita JH. Prevention of pericyte ghost formation in retinal capillaries of galactose-fed dogs by aldose reductase inhibitors. Arch Ophthalmol 1988; 106: 1099–1102.

    Google Scholar 

  10. Lightman S, Rechthand E, Terubayashi H, Palestine A, Rapoport S, Kador P. Permeability changes in blood-retinal barrier of galactosemic rats are prevented by aldose reductase inhibitors. Diabetes 1987; 36: 1271–1275.

    Google Scholar 

  11. Poulsom R. Inhibition of aldose reductase from human retina. Curr Eye Res 1987; 6: 427–432.

    Google Scholar 

  12. van Gerven JMA, Boot JP, Lemkes HHPJ, van Best JA, Oosterhuis JA. Effects of tolrestat, an aldose reductase inhibitor, on diabetic retinopathy. A six months double blind trial. In: van Gerven JMA. Aldose reductase inhibitor treatment in diabetic complications. Thesis. 1990.

  13. Cunha-Vaz JG, Mota CC, Leite EC, Abreu JR, Ruas MA. Effect of sulindac on the permeability of the blood-retinal barrier in early diabetic retinopathy. Arch Ophthalmol 1985; 103: 1307–1311.

    Google Scholar 

  14. Cunha-Vaz JG, Mota CC, Leite EC, Abreu JR, Ruas MA. Effect of sorbinil on bloodretinal barrier in early diabetic retinopathy. Diabetes 1986; 35: 574–578.

    Google Scholar 

  15. Muntoni S, Basciu M, Mascia C, et al. Reversal of diabetic dyschromatopisa by pharmacological treatment [Abstract]. Diabetologia 1986; 29, 574A.

    Google Scholar 

  16. Hotta N, Kakuta H, Fukasawa H, et al. The clinical trial of aldose reductase inhibitor on diabetic retinopathy. Diabetes 1986; 35 (suppl. 1): 213A.

    Google Scholar 

  17. Christensen JEJ, Varnek L, Gregersen G. The effect of an aldose reductase inhibitor (sorbinil) on diabetic neuropathy and neural function of the retina: a double blind study. Acta Neurol Scand 1985; 71: 164–167.

    Google Scholar 

  18. Sorbinil Retinopathy Trial Research Group. A randomized trial of sorbinil, an aldose reductase inhibitor, in diabetic retinopathy. Arch Ophthalmol 1990; 108: 1234–1244.

    Google Scholar 

  19. Yagihashi S, Kamijo M, Ido Y, Mirrlees DJ. Effects of long-term aldose reductase inhibition on development of experimental diabetic neuropathy. Diabetes 1990; 39: 690–696.

    Google Scholar 

  20. Blohmé G, Smith U. Aldose reductase inhibition reduces urinary albumin excretion rate in incipient diabetic nephropathy. Diabetologia 1989; 32: 476A.

    Google Scholar 

  21. Pedersen MM, Christiansen JS, Mogensen CE. Renal effects of an aldose reductase inhibitor (Statil) during 6 months treatment in type I diabetic patients. Diabetologia 1989; 32: 516A.

  22. Gill JS, et al. ‘Statil’: effect on diabetic peripheral and autonomic neuropahty and circulating neuropeptides. Diabetologia 1988; 31: 494A.

    Google Scholar 

  23. Klein BEK, Davis MD, Segal P, Long JA, Harris WA, Haug GA, Magli YL, Syrjala S. Diabetic retinopathy, assessment of severity and progression. Ophthalmology 1984; 91: 10–17.

    Google Scholar 

  24. Akagi Y, Yajima Y, Kador PF, Kuwabara T, Kinoshita JH. Localization of aldose reductase in the human eye. Diabetes 1984; 33: 562–566.

    Google Scholar 

  25. Kennedy A, Frank RN, Varma SD. Aldose reductase activity in retinal and cerebral microvessels and cultured vascular cells. Invest Ophthalmol Vis Sci 1983; 24: 1250–1258.

    Google Scholar 

  26. Klein R, Meuer SM, Moss SE, Klein BEK. The relationship of retinal microaneurysm counts to the 4-year progression of diabetic retinopathy. Arch Ophthalmol 1989; 107: 1780–1785.

    Google Scholar 

  27. Frank RN. On the pathogenesis of diabetic retinopathy, Ophthalmology 1984; 91: 626–634.

    Google Scholar 

  28. Merimee TJ. Diabetic retinopathy, a synthesis of perspectives. New Engl J Med 1990; 322: 978–983.

    Google Scholar 

  29. Palmberg P, et al. The natural history of retinopathy in insulin-dependent juvenile-onset diabetes. Ophthalmology 1981; 88: 613–618.

    Google Scholar 

  30. Davis MD, Hubbard LD, Trautman J, Klein R. Methodology for the study and classification of diabetic retinopathy in juvenile onset diabetic patients included in the Kroc study. Diabetes 1985; 34 (suppl. 3): 42–49.

    Google Scholar 

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Tromp, A., Hooymans, J.M.M., Barendsen, B.C. et al. The effects of an aldose reductase inhibitor on the progression of diabetic retinopathy. Doc Ophthalmol 78, 153–159 (1991). https://doi.org/10.1007/BF00165675

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