Can ACE Inhibitors Slow Diabetic Retinopathy?

July 6, 2009

A recent article reports that diabetic patients on renin-angiotensin inhibitors may experience up to a 70% reduction in the development o f diabetic retinopathy.  On the other hand, neither ACE (angiotensin converting enzyme) inhibitors nor ARBs (angiotensin-receptor blocker) slowed the progression of nephropathy.

While several markers of renal function such as microalbuminuria and creatinine clearance varied in the study, the five year renal function rate, as measured by the GFR, between treated and control group was the same, that is, the ACE/ARB group did not show any renal benefit.  These findings are contrary to the accepted practice that ACE inhibitors/ARBs exhibit protection from nephropathy.  Additional, prospective studies are necessary.

Progression of retinopathy was a new finding, but the study was unable to correlate blood pressure with progression of the diabetic retinopathy, that is, the researchers could not determine if the effects on diabetic retinopathy were simply due to controlled blood pressure versus the actual medications.  Again, prospective trials may be needed to answer this.

Randall V. Wong, M.D.
Retinal Specialist




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