Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Proanthocyanidins are a class of polyphenolic compounds found in various plants, such as grape seeds, pine bark, and certain fruits. Their use in diabetic retinopathy is primarily supported by preclinical and some early clinical evidence, though robust, large-scale human trials are lacking. The proposed benefit in diabetic retinopathy comes from their antioxidant, anti-inflammatory, and vascular-protective properties. In diabetic retinopathy, oxidative stress and microvascular damage play a key role in disease progression. Proanthocyanidins have been shown in animal models and in vitro studies to reduce oxidative damage and capillary permeability, potentially slowing or preventing retinal damage. Some small clinical studies, such as trials using grape seed extract or pine bark extract (Pycnogenol®), have suggested improvements in retinal microcirculation, reduction in retinal edema, and stabilization of visual function in diabetic patients. However, these studies have limitations: small sample sizes, short duration, and sometimes lack of rigorous controls. There is also heterogeneity regarding the source and standardization of proanthocyanidin preparations used. In summary, while there is a plausible mechanism of action and some preliminary clinical support for proanthocyanidins in diabetic retinopathy, the evidence is not yet strong or definitive. Further well-designed, larger randomized controlled trials are needed to establish their efficacy and safety for this indication.

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