Fidia Ophthalmics, 95125 Catania, Italy.
Department of Biology, University of Pisa, 56123 Pisa, Italy.
Medicina (Kaunas). 2023 Jul 20;59(7):1334. doi: 10.3390/medicina59071334.
In this review, we aim to provide an overview of the recent findings about the treatment of neovascular retinal diseases. The use of conventional drugs and nutraceuticals endowed with antioxidant and anti-inflammatory properties that may support conventional therapies will be considered, with the final aim of achieving risk reduction (prevention) and outcome improvement (cooperation between treatments) of such sight-threatening proliferative retinopathies. For this purpose, we consider a medicinal product one that contains well-defined compound(s) with proven pharmacological and therapeutic effects, usually given for the treatment of full-blown diseases. Rarely are prescription drugs given for preventive purposes. A dietary supplement refers to a compound (often an extract or a mixture) used in the prevention or co-adjuvant treatment of a given pathology. However, it must be kept in mind that drug-supplement interactions may exist and might affect the efficacy of certain drug treatments. Moreover, the distinction between medicinal products and dietary supplements is not always straightforward. For instance, melatonin is formulated as a medicinal product for the treatment of sleep and behavioral problems; at low doses (usually below 1 mg), it is considered a nutraceutical, while at higher doses, it is sold as a psychotropic drug. Despite their lower status with respect to drugs, increasing evidence supports the notion of the beneficial effects of dietary supplements on proliferative retinopathies, a major cause of vision loss in the elderly. Therefore, we believe that, on a patient-by-patient basis, the administration of nutraceuticals, either alone or in association, could benefit many patients, delaying the progression of their disease and likely improving the efficacy of pharmaceutical drugs.
在这篇综述中，我们旨在概述最近关于治疗新生血管性视网膜疾病的发现。我们将考虑使用具有抗氧化和抗炎特性的传统药物和营养保健品来支持传统疗法，最终目的是降低此类威胁视力的增生性视网膜病变的风险（预防）和改善治疗效果（治疗协同作用）。为此，我们将具有明确化合物且具有已证实的药理学和治疗作用的药物视为一种治疗方法，该方法通常用于治疗已确诊的疾病。很少有处方药用于预防目的。膳食补充剂是指用于预防或辅助治疗特定疾病的化合物（通常是提取物或混合物）。但是，必须记住，药物-补充剂之间可能存在相互作用，并可能影响某些药物治疗的疗效。此外，药物和膳食补充剂之间的区别并不总是那么明确。例如，褪黑素被制定为治疗睡眠和行为问题的药物；低剂量（通常低于 1 毫克）时，它被认为是一种营养保健品，而高剂量时，它被作为精神药物出售。尽管它们在药物方面的地位较低，但越来越多的证据支持膳食补充剂对增生性视网膜病变有益的观点，增生性视网膜病变是老年人视力丧失的主要原因。因此，我们认为，对于每个患者，单独或联合使用营养保健品都可能使许多患者受益，延缓疾病进展，并可能提高药物的疗效。
