Diabetic retinopathy

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Contents

Introduction

  • Leading cause of visual loss in young adults
    • Usually from central macular oedema secondary to leakage protein and fluid from damaged capillaries
    • Otherwise from proliferative diabetic retinopathy
  • Justifies eye screening programs in diabetics

Associations

Treatment

  • Good control of diabetes[3]
  • Good control of blood pressure[4]
  • Laser photocoagulation[5]
    • Target ischaemic retina and microaneurysms
    • Arrests progression at cost of permanently damaged retina
  • Fibrates
  • There is no good evidence for statins being effective[7]
  • Early vitrectomy in proliferative retinopathy and severe vitreous haemorrhage[8]
  • Studies are currently underway (2007) with [9]:
    • Vascular proliferation inhibitors such as bevacizumab
    • Protein kinase C inhibitors
    • Angiotensin converting enzyme inhibitors such as captopril
    • Growth hormone
    • Intravitreal injections of steroids

This article is a work in progress. Please feel free to contribute to it.


References

  1. Klein R, Klein BE, Moss SE, Wong TY. Retinal vessel caliber and microvascular and macrovascular disease in type 2 diabetes: XXI: the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Ophthalmology. 2007 Oct; 114(10):1884-92.(Link to article – subscription may be required.)
  2. van Hecke MV, Dekker JM, Nijpels G, Teerlink T, Jacobs C, Stolk RP, Heine RJ, Bouter LM, Polak BC, Stehouwer CD. Homocysteine, S-adenosylmethionine and S-adenosylhomocysteine are associated with retinal microvascular abnormalities: the Hoorn Study. . 2007 Oct 24.(Epub ahead of print) (Link to article – subscription may be required.)
  3. Mohamed Q, Gillies MC, Wong TY. Management of diabetic retinopathy: a systematic review. JAMA : the journal of the American Medical Association. 2007 Aug 22; 298(8):902-16.(Link to article – subscription may be required.)
  4. Mohamed Q, Gillies MC, Wong TY. Management of diabetic retinopathy: a systematic review. JAMA : the journal of the American Medical Association. 2007 Aug 22; 298(8):902-16.(Link to article – subscription may be required.)
  5. Mohamed Q, Gillies MC, Wong TY. Management of diabetic retinopathy: a systematic review. JAMA : the journal of the American Medical Association. 2007 Aug 22; 298(8):902-16.(Link to article – subscription may be required.)
  6. Keech A, Mitchell P, Summanen P, O'Day J, Davis T, Moffitt M, Taskinen MR, Simes R, Tse D, Williamson E, Merrifield A, Laatikainen L, d'Emden M, Crimet D, O'Connell R, Colman P. Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study): a randomised controlled trial. . 2007 Nov 5.(Epub ahead of print) (Link to article – subscription may be required.)
  7. Zhang J, McGwin G. Association of statin use with the risk of developing diabetic retinopathy. Archives of ophthalmology. 2007 Aug; 125(8):1096-9.(Link to article – subscription may be required.)
  8. Mohamed Q, Gillies MC, Wong TY. Management of diabetic retinopathy: a systematic review. JAMA : the journal of the American Medical Association. 2007 Aug 22; 298(8):902-16.(Link to article – subscription may be required.)
  9. Yam JC, Kwok AK. Update on the treatment of diabetic retinopathy. Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine. 2007 Feb; 13(1):46-60.
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