When in the course of diabetes do you envision aldose reductase inhibitors having the most benefit?
I would see aldose reductase inhibitors as prophylactic drugs—that is, preventative drugs. Our goal is to develop inhibitors that can be used not just to treat existing retinopathy, but also to prevent the onset and progression of retinopathy in the future. There are very powerful new drugs available to control the neovascular growth in the late stages of retinopathy. These are called vascular endothelial growth factor inhibitors, such as Lucentis. (After the initial damage to the retina occurs, the body tries to heal by growing new blood vessels. This is called neovascularization. Unfortunately, the process only makes things worse and propels the patient from vision loss to blindness. Blocking neovascularization at this stage allows patients to retain some vision). VEGF inhibitors are very good at reducing the fragility of the neovascular vessels that grow in the retina, but please understand that this occurs as one of the late stages of advanced retinopathy. A lot of bad things have
