Calcium dobesilate in the treatment of diabetic retinopathy: don’t waste the time

Gusev Yu.A., Kapkova S.G., Varkentina I.V., Tret'yak E.B.

Clinical Hospital № 86 of Federal Medical Biological Agency, Moscow

Summary. The metabolic pathways triggered by hyperglycemia, i.e., the polyol and the hexosamine pathways, the synthesis de novo of diacylglycerol-proteinkinase C, oxidative stress and advanced glycation end-products, as well as chronic inflammation are instrumental in the onset and progression of diabetic retinopathy (DR). Therapeutics that are targeting multiple pathophysiological mechanisms may be more effective in preventing disease progression. Hence, conservative treatment of diabetic microvascular complications should include microcirculation correctors (angioprotective and antiplatelet agents). Calcium dobesilate/CaD (Doxi-Hem®) is included in the standards of medical care in DR. CaD is characterized by antioxidant and antiradical activities and angioprotective action. It prevents the blood-retinal barrier breakdown by restoring tight junction protein levels and decreasing leukocyte adhesion to retinal vessels. CaD also inhibits vascular endothelial growth factor (which induces endothelial cell proliferation) and reduces retinal albumin leakage. Finally, CaD reduces thrombocyte aggregation and decreases hyperviscosity in blood through a fibrinogen-lowering effect. Clinically, CaD improves ocular fundus by reducing the number of microaneurysms and intraretinal haemorrhages and promoting their resorption as well as by reducing the number and the sizes of soft exudates. CaD provides long-term remission of DR course and decreases the risk of complications after photocoagulation. Doxi-Hem® is effective in early DR terms of prevention of its further progression and reversing pre-existing abnormalities.
Key words: calcium dobesilate, mechanism of action, microvascular complications, diabetic retinopathy.
For citation: Gusev Yu.A., Kapkova S.G., Varkentina I.V., Tret'yak E.B. Calcium dobesilate in the treatment of diabetic retinopathy: don’t waste the time // RMJ. Clinical ophthalmology. 2016. № 1. P. 50–54.