The efficacy of somatostatin analogues in the treatment of diabetic retinopathy and thyroid eye disease

Somatostatin, a polypeptide hormone of 14 or 28 aminoacids, is produced by neuroendocrine, inflammatory and immune cells. It has multiple inhibitory functions on the secretion of various hormones and growth factors and modulates several cellular functions. Somatostatin analogues provide an elegant pharmacological principal to modify the high-risk form of proliferative diabetic retinopathy. Pilot investigations have provided evidence that octreotide can very effectively suppress new bleeding and stop visual loss in patients who have failed conventional photocoagulation therapy. In this cohort, octreotide was found to be a safe treatment modality. The same applies also for thyroid eye disease, in which some non-randomized, as well as randomized studies have shown a beneficial effect. More potent analogues, like SOM230, which are not yet in the market, can be proved to have a better therapeutic outcome in such patients and may be considered a safe treatment modality to stop the progression from pre-proliferative to proliferative diabetic retinopathy. This is also true for adolescent patients with thyroid eye disease, as well as for adults who also suffer from diabetes mellitus.