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Despite recent advances in pharmacotherapy for diabetic macular edema (DME), satisfying anatomical and visual results are not always achieved. Improved understanding of the mechanisms underlying diabetic retinopathy may pave the way for new treatment modalities for DME that is refractory to current therapies.
In addition to high vascular endothelial growth factor levels,1 increased activity of the Rho/ROCK pathway has recently been demonstrated in retinal vessels of diabetic rats.2 Experimental studies have demonstrated that fasudil hydrochloride, a potent ROCK inhibitor, can suppress leukocyte adhesion and prevent neutrophil-induced retinal endothelial cell damage.2
Ahmadieh H, Nourinia R, Hafezi-Moghadam A. Intravitreal Fasudil Combined With Bevacizumab for Persistent Diabetic Macular EdemaA Novel Treatment. JAMA Ophthalmol. 2013;131(7):923-924. doi:10.1001/jamaophthalmol.2013.143