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Oxygen therapy may improve vision worsened by diabetes

surements would change by such magnitudes by chance is very small," Campochiaro says.

Once the oxygen therapy was discontinued, vision slowly worsened in some eyes. But in four eyes in which retinal thickness had returned to the normal range while on oxygen, the improvement was maintained even after oxygen was stopped. Since these patients all had previous laser therapy, it is possible that the reduced thickening of the macula achieved by oxygen allowed the laser to exercise a stabilizing effect.

Diabetic macular edema affects up to 10 percent of all patients with diabetes. It is caused when high blood sugar, through a cascade of events, causes damage in normal retinal blood vessels and a decrease in the supply of oxygen and nutrients. Campochiaro and Quan Dong Nguyen, M.D., the principal investigator on the study, hypothesize that the retina, when faced with a decrease in oxygen, releases vascular endothelial growth factor (VEGF) and other substances that cause retinal blood vessels to become leaky and ultimately stimulate the growth of new blood vessels. The leakage of fluid into the macula causes it to become thickened and results in vision loss.

Supplemental oxygen reduces production of VEGF and similar proteins, which in turn reduces the amount of leaking in retinal vessels and lessens the severity of macular edema. The treatment could reduce the thickness of the retina before laser treatment, making the laser more effective and more likely to maintain stability without supplemental oxygen. Alternately, supplemental oxygen could be combined with newer treatments that directly target VEGF. For example, Campochiaro and colleagues also studied an oral drug that blocks receptors for VEGF, called PKC412, which was found to significantly reduce macular edema and improve visual acuity in diabetics. This first demonstration of directly targeting VEGF was reported by the researchers in another study published in the March issue of the jo
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Contact: John Lazarou
jlazaro1@jhmi.edu
410-502-8902
Johns Hopkins Medical Institutions
17-May-2004


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