New strategy to treat diabetic retinopathy using stabilization of hyalocyte-vasucular endothelial cell correlation

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Ocular angiogenesis is regulated by polypeptides including cytokines, which are known to affect vascular endothelial cells. We have investigated that hyalocytes interact with vascular endothelial cells, and some cytokines affect these interactions. To determine the effect of various chemically active agents on the viability of endothelial cells alone and cocultured with hyalocytes. The viability of human retinal endothelial cells (HREC_s) was determined after exposure to IL-1α, IL-1β, IL-6, TNFα and VEGF using the MTT assay. These results were compared to the viability when the HRECs were cocultured with porcine hyalocytes that had been exposed to different types of cytokines. The effects of bevacizumab, fenofibrate and dexamethasone on the viability of HRECs in coculture with hyalocytes were also assessed. Ten micrograms/millilitre of bevacizumab decreased the percentage of living HRECs stimulated by VEGF without hyalocytes, but with the hyalocytes, 100 μg/ml of bevacizumab was requir … More ed to decrease the percentage of viable HRECs stimulated by VEGF. Dexamethasone at 50 μg/ml, decreased the viability of HRECs stimulated by IL-1α, IL-1β, IL-6 and VEGF without hyalocytes but could not decrease the viability of HRECs cocultured. Coculturing HRECs with vitreous-derived hyalocytes depressed the effects of cytokines, bevacizumab, fenofibrate and dexamethasone. This suggests that the vitreal hyalocytes may play a role in pathogenic endothelial cell proliferation in vivo. In addition, inflammatory processes play important roles in diabetic retinopathy and maculopathy involving hyalocytes and endothelial cells.Upon the above results, we examined the effects of steroid eye drops to treat diabetic maculopathy. We evaluated the efficacy of treatment refractory diabetic macular edema (DME) after vitrectomy with difluprednate ophthalmic emulsion 0.05% (DurezolR). This study enrolled patients with refractory diabetic macular edema in our clinic. In all subjects, more than 3 months had passed since any prior treatments. The subject eyes were treated with Durezol^(R) 4 times daily for the first month, and then twice daily for 2 months (eye drop group). The mean retinal thickness was improved significantly. Instillation of difluprednate ophthalmic emulsion 0.05% is a safe and effective treatment modality that does not require surgical intervention and does not produce severe side effects. Less