The risk of ocular diseases in diabetics is 25 times that of the general population.

Helping New Mexicans See Clearly: UNM Researchers Develop Drug Therapy for Diabetic Retinopathy by Cathleen Rineer-Garber Diabetes is one of the state's greatest health concerns. For the 120,000 New Mexicans diagnosed with the disease, maintaining their health and quality of life is a constant struggle. From foot problems to kidney failure, the disease can cause numerous complications - one of the most prevalent being the loss of vision. Arup Das, MD/PhD, examines a patient. According to the National Diabetes Data group, the risk of ocular diseases in diabetics is 25 times that of the general population. Diabetics have an increased risk of developing cataracts and glaucoma; however, the most common risk to vision is diabetic retinopathy. Diabetic retinopathy affects tiny blood vessels inside the retina -- the light-sensitive tissue at the back of the eye. According to Arup Das, MD/PhD, a retinal specialist and Associate Professor in the UNM Department of Surgery, when blood vessels in the eye suffer damage, the body produces new ones to replace them. "Unfortunately, the new blood vessels can contribute to further complications," said Das. The growth of new blood vessels -- called angiogenesis -- results in fragile retinal vessels which can break down or leak, resulting in severe vision impairment and blindness. In fact, with between 12,000-24,000 new cases of blindness attributed to retinopathy each year, it is the leading cause of blindness in American adults 20-64 years old. For many diabetics, retinopathy is inevitable. According to the National Institutes of Health, 90 percent of Type I (younger onset) diabetics and 65 percent of Type II (adult onset) diabetics will develop retinopathy within 10 years after developing diabetes. In New Mexico, more than 37,000 people have been diagnosed with diabetic retinopathy. For Das, who says that 90 percent of the patients he sees in his clinic at UNM Hospital are diabetics, finding ways to improve treatment of retinopathy is a primary concern. Currently, the most common treatment is to destroy the new vessels with a laser. "This approach is effective in preserving central vision in about 70 percent of patients, but it usually destroys the patient's peripheral vision," said Das. The result is that the patient's vision at night and in low-light conditions is impaired. Paul McGuire, Ph.D. Das, determined to find a way to treat retinopathy without compromising peripheral vision, teamed up with Paul McGuire, PhD, Professor of Cell Biology and Physiology at UNM. In 1997, they received a grant from the National Institutes of Health to research ways to suppress angiogenesis and prevent blindness. The research team has focused much of the work on using protease inhibitors to slow the growth of new blood vessels in the eyes. Proteases are enzymes that help break down existing blood vessels enabling new vessels to grow. Now in their sixth year of the study, Das and McGuire have made significant progress in developing an effective pharmacological approach to diabetic retinopathy. According to Das, using drug therapy to treat retinopathy will minimize tissue damage and eliminate side effects associated with laser therapy. A pharmacological approach will also provide alternative delivery methods, including oral drugs and eye drops. This, according to McGuire, is a much welcome alternative to surgery, lasers or eye injections. The team believes that in addition to providing a more effective treatment, these new delivery options will attract more people to seek treatment. There's even more good news for patients. According to Das, the protease inhibitor will also be effective in treating other ocular conditions caused by angiogenesis, such as age-related macular degeneration, which affects nearly 10,000 New Mexicans. The protease inhibitor used by Das and McGuire is currently being tested in clinical trials in patients with macular degeneration. Future clinical trials will focus on the use of the inhibitor in treatment of diabetic retinopathy. Missed a feature story? Click here to browse our features archive.

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