Abordajes terapéuticos farmacológicos avanzados para las alteraciones de la superficie ocular en diabetes mellitus tipo 1 y tipo 2: revisión exploratoria de la literatura

Abstract

Objective: To describe advanced pharmacological therapeutic approaches for ocular surface alterations in patients with type 1 and type 2 diabetes mellitus, as reported in the literature. Methods: An exploratory literature review was conducted on advanced pharmacological therapeutic approaches for ocular surface disorders associated with type 1 and type 2 diabetes mellitus. The databases PubMed, Scopus, ScienceDirect, SciELO, and Google Scholar were searched. Publications from the previous ten years in English and Spanish were considered, and predefined inclusion and exclusion criteria were applied. Data from the selected studies were organized in an extraction matrix to characterize the publications, identify the therapies evaluated, and synthesize the reported clinical outcomes. Results: A total of 27 studies were included in the exploratory review. The identified therapeutic approaches included topical immunomodulators, such as cyclosporine A and lifitegrast; secretagogues, such as diquafosol and rebamipide; and blood-derived biological therapies, including autologous serum, platelet-rich plasma (PRP), and plasma rich in growth factors (PRGF). The studies reported favorable outcomes in several ocular surface parameters, including dry eye symptoms, tear film stability, corneal staining, and epithelial repair. However, a substantial proportion of the therapeutic evidence came from studies involving patients with dry eye disease who were not specifically selected for diabetes mellitus, limiting the extent to which these benefits can be directly attributed to the diabetic population. Conclusions: The exploratory review identified several advanced pharmacological therapeutic approaches for managing ocular surface disorders. The included studies reported benefits across different clinical parameters; however, evidence specifically involving patients with diabetes mellitus was limited. Further clinical research focused on this population is needed to establish the efficacy and safety of the identified therapies more precisely.