A proposal for improvement of the first-line treatment of advanced diabetic retinopathy

Diabetic retinopathy (DR) can be resulted from high blood glucose levels that may damage the retinal pigment epithelium, located between the vascular choroids and the neurosensory retina, which functions as a barrier. The first-line treatment of DR comprises an anti-vascular endothelial growth factor (anti-VEGF) compound such as Avastin (bevacizumab), Lucentis (ranibizumab) and Eylea (aflibercept). Some patients suffering from static condition of advanced DR need a treatment that will lead to improvement of the DR condition, e.g., reduction of abnormal blood vessels on the optic disc and preventing further ischemic optic neuropathy. Thus, a combined simultaneous treatment of an anti-VEGF compound such as Avastin, or a biosimilar version, and oral administration of fucoxanthin that has a protective effect on the retina, optionally together with vitamin A, is proposed for treating advanced DR.