Diabetic Retinopathy

Excerpt

Diabetic retinopathy (DR) is a microvascular disorder occurring due to the long-term effects of diabetes mellitus. Diabetic retinopathy may lead to vision-threatening damage to the retina, eventually leading to blindness. It is the most common cause of severe vision loss in adults of working age groups in the western world. Early detection and timely intervention are the keys to avoiding blindness due to diabetic retinopathy. The number of patients with diabetic retinopathy in America is estimated to reach 16.0 million by 2050, with vision-threatening complications affecting around 3.4 million of them. The usefulness of strict glycemic control was clearly seen in clinical trials like the UK Prospective Diabetes Study (UKPDS) and Diabetes Control and Complication Trial (DCCT).

Uncontrolled diabetes can lead to many ocular disorders like cataracts, glaucoma, ocular surface disorders, recurrent stye, non-arteritic anterior ischemic optic neuropathy, diabetic papillopathy, and diabetic retinopathy. Diabetic retinopathy may lead to vision-threatening damage to the retina, eventually leading to blindness; it is the most common and severe ocular complication. Poor glycemic control, uncontrolled hypertension, dyslipidemia, nephropathy, male sex, and obesity are associated with worsening diabetic retinopathy. Typical fundus features of diabetic retinopathy include microaneurysms, hard exudates, macular edema (diabetic macular edema or DME), and new vessels (in proliferative DR or PDR). The management options include strict control of the systemic conditions, intravitreal pharmacotherapy, and laser photocoagulation. With early diagnosis and prompt management, good final visual acuity may be achieved in most patients with DR.