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. 2011 Apr;25(2):99-111.
doi: 10.1016/j.sjopt.2011.01.009. Epub 2011 Jan 31.

Diabetic retinopathy - An update

Abdulrahman A Alghadyan  1
Affiliations

Diabetic retinopathy - An update

Abdulrahman A Alghadyan. Saudi J Ophthalmol. 2011 Apr.

Abstract

Management of diabetes should involve both systemic and ocular aspects. Control of hyperglycemia, hypertension and dyslipidemia are of major role in the management of diabetic retinopathy. In the ocular part; laser treatment remains the cornerstone of treatment of diabetic macular edema (focal/grid), severe non-proliferative and proliferative diabetic retinopathy (panretinal photocoagulation). There is a strong support to combination therapy. Using one or two intravitreal injections such as anti-VEGF and or steroid to reduce central macular thickness followed by focal or grid laser to give a sustained response may offer an alternative to treatment in diabetic macular edema. Anti-VEGF were found to be effective as an adjunct therapy in proliferative diabetic retinopathy patient who is going to have vitrectomy for vitreous hemorrhage with neovascularization, panretinal photocoagulation, and other ocular surgery such as cases with neovascular glaucoma and cataract with refractory macular edema.

Keywords: Anti-VEGF; Diabetic retinopathy; Laser; Management; Pathophysiology; Steroids.

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Figures

Figure 1
Figure 1
This schematic shows the four biochemical pathways that lead to diabetic retinopathy. DHAP, dihydroxyacetone phosphate; DAG, diacylglycerol; PKC, protein kinase C; GAPDH, glyceraldehyde 3-phosphate dehydrogenase; AGEs, advanced glycation end products, UDP-GlcNAC, N-acetylglucosamine.
Figure 2
Figure 2
Moderate non-PDR with CSME.
Figure 3
Figure 3
Non PDR with early sign of ischemia of the fovea; (a) clinical photo and (b) fluorescein angiogram.
Figure 4
Figure 4
Ischemic optic neuropathy (note white swelling of the disk).
Figure 5
Figure 5
PDR with NVD in photo (a), and NVE supra temporal in photo (b).
See this image and copyright information in PMC

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