Calcium dobesilate combined with candesartan in the treatment of proliferative diabetic retinopathy and its effect on TGF-b1, VEGF and IL-19 levels in the vitreous humor

Abstract

Purpose: To investigate the efficacy of a combination therapy involving calcium dobesilate and candesartan in the treatment of proliferative diabetic retinopathy and its impact on the transforming growth factor b1 (TGF-b1), vascular endothelial growth factor (VEGF) and interleukin-19 (IL-19) levels in the vitreous humor. Methods: Between January 2020 and May 2023, 112 patients with proliferative diabetic retinopathy from Handan City Eye Hospital, China were enrolled in this study. They were divided into two groups: study group (n = 56) - orally administered 500 mg of calcium dobesilate combined with 50 mg of candesartan daily - and control group (n = 56), received calcium dobesilate only. Patients began treatment with calcium dobesilate and candesartan as soon as diabetic retinopathy was diagnosed. Treatment efficacy, changes in hemorrhage area, macular thickness and best-corrected visual acuity were assessed before and after treatment (for a duration of 60 days). Results: Study group had significantly higher (p < 0.05) treatment efficacy compared to control group, achieving a total effective rate of 92.86 %. It also exhibited reduced hemorrhage area and macular thickness, which were significantly lower (p < 0.05) than those in control group. Best-corrected visual acuity was significantly higher in the study group (p < 0.05) followed by improved peak systolic velocity and end-diastolic velocity after treatment (p < 0.05). Additionally, TGF-b1, VEGF and IL-19 levels in the vitreous humor were significantly lower in study group compared to control group (p < 0.05). Conclusion: The combination of calcium dobesilate and candesartan demonstrates significant therapeutic efficacy in treating proliferative diabetic retinopathy while reducing the TGF-b1, VEGF and IL-19 levels in the vitreous humor. Large-scale studies are needed to validate these findings and delve into treatment mechanisms and long-term effects.