Diabetic retinal disease

Abstract

Diabetic retinopathy is a complication of diabetes mellitus that is clinically characterized by changes in retinal microvasculature. Diabetic retinopathy is now better defined as diabetic retinal disease (DRD), as diabetes mellitus affects not only the retinal microvasculature but the whole retina, including neurons and glia. A global concerted effort to study preclinical and clinical signs of DRD and their association with visual acuity and patient-reported vision-related quality of life, and the integration of these features with systemic health and biochemical milieu in people with diabetes mellitus is underway. The Diabetic Retinopathy Clinical Research Retina Network trials and other researchers have provided substantial robust evidence on the current management of vision-threatening diabetic retinopathy that includes proliferative diabetic retinopathy and diabetic macular oedema. Progress is also being made to develop, evaluate and implement cost-effective strategies for personalized screening, treatment and monitoring, incorporating artificial intelligence as clinical decision support tools, where appropriate. In addition, novel therapies and modes of delivery are being evaluated to increase durability of interventions and improve affordability to improve vision-related quality of life and reduce the global burden of blindness owing to DRD.