The possibility of ROCK inhibitor for diabetic retinopathy treat

• Project/Area Number: 16K11270
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Ophthalmology
• Research Institution: Dokkyo Medical University
• Principal Investigator: Tetsuya Muto 獨協医科大学, 医学部, 講師 (40364608)
• Co-Investigator(Kenkyū-buntansha): 町田 繁樹 獨協医科大学, 医学部, 教授 (30285613)
• Project Period (FY): 2016-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥3,770,000 (Direct Cost: ¥2,900,000、Indirect Cost: ¥870,000); Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2017: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000); Fiscal Year 2016: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000)
• Keywords: ROCK / ファスジル / 硝子体注射 / 糖尿病黄斑症 / 視力 / 網膜中心窩厚 / ROCK阻害薬 / 糖尿病黄斑浮腫 / 医学 / 糖尿病

Outline of Final Research Achievements

Lately, intravitreal injection of anti-vascular endothelial growth factor antibody and steroid sub-tenon injection are widely used for diabetic maculopathy treatment. However, these drugs are sometimes ineffective and another new drugs are desired. Fasdudil, a selective Rho/Rho-kinase inhibitor were injected for 14 eyes of 13 patients with diabetic maculopathy (65.7±5.2 years). As all investigated factors, such as visual acuity, intraocular pressure, retail foveal thickness, central visual field and electroretiogram unchanged, fasudil might not have severe side effects. However, this amount of concentration (0.025mg/0.05ml) or numbers of injection times were ineffective for diabetic maculopathy.

Academic Significance and Societal Importance of the Research Achievements

糖尿病網膜症は、黄斑症、硝子体出血、牽引性網膜剥離、血管新生緑内障など実に多彩な病変を呈する。現状では、網膜光凝固、硝子体手術、硝子体注射の合わせ技で治療を行っているが、治療方法がひとつ増えると、それに伴い今後の発展が多いに期待される。今回の結果からファスジル硝子体注射の安全性の面では問題ないといえるが、効果の面では問題がある。過去にヒト糖尿病黄斑症に対して抗血管内皮増殖因子抗体のベバシズマブとファスジル硝子体注射の併用で副作用もなく、非常に有効であったとの報告があるので、他剤との併用や投与量の変更、注射の反復なども念頭に置き、再度検討したいと思っている。