Background: Diabetic retinopathy (DR) is a major complication of diabetes, characterized
by extensive vascular pathology leading to vision loss. Neuronal suffering and death are also
present in the diabetic retina as a result of different molecular mechanisms that are compromised or
modified in response to high glucose. The aim of this paper is to highlight recent data indicating
that neurodegeneration is likely to play a primary role in the development of DR and that strategies
based on nanomedicine may be exploited to deliver neuroprotection to the retina.
Methods: An extensive analysis of the publications dealing with the role of neuroprotection in DR
and with nanoparticle-mediated drug delivery to the retina has been conducted using PubMed, with
particular attention to the most recent papers.
Results: There are important limitations related to possible systemic side effects of neuroprotective
substances and to drug bioavailability in the retina such as, for instance, the amount of drug reaching
the retina, the need of keeping to a minimum the number of administrations (especially, for
example, in the case of intraocular injections) and the need of assuring a long-lasting, graded intraocular
drug delivery. In recent years, a variety of investigations have been aimed at the exploitation
of approaches of nanomedicine to enhance the pharmacokinetics and pharmacodynamic activity
of intraocularly delivered drugs. In particular, we provide some preliminary results that we have
obtained about the feasibility of delivering magnetic nanoparticles functionalized with a neuroprotectant
to mouse eyes through intraocular injections.
Conclusion: We propose that nanoparticles functionalized with neuroprotective substances may be
used to protect the diabetic retina, thus causing an impact in the design of future pharmacologic
treatments for DR.