Current Diabetes Reviews - Volume 5, Issue 1, 2009

This issue of CDR contains a range of interesting and up-to-date articles which review the most recent advances in the Treatment of Diabetic Retinopathy and which are written by highly respected groups of investigators. Although laser photocoagulation is considered to be the standard treatment of Diabetic Retinopathy for both macular edema and for retinal neovascularization, there have recently been important adva Read More

The Early Treatment Diabetic Retinopathy Study (ETDRS) identified important risk factors for progression to high risk proliferative diabetic retinopathy (PDR) including retinopathy severity, decreased visual acuity, and high levels of hemoglobin A1C (HbA1c). Additional risk factors for progression to PDR are decreased hematocrit and increased serum lipids. The long-term benefit of improving glycemic control was eval Read More

Diabetic retinopathy, a secondary microvascular complication of diabetes mellitus is the leading cause of blindness in the Unites States amongst individuals age 20 to 64. Two major retinal problems cause most of the diabetesrelated vision loss: diabetic macular edema and complications from abnormal retinal blood vessel growth, angiogenesis. Secondary to angiogenesis, increased retinal blood flow is of pathogenic importanc Read More

Diabetic retinopathy (DR) and diabetic macular edema (DME) are frequent long term ocular complications in diabetic patients and may produce serious effects on visual acuity (VA), sometimes leading to blindness. The high and increasing prevalence of diabetes worldwide suggests that both complications will continue to be the main cause of vision loss and associated impairment for a long time [1]. The development and pro Read More

Diabetic macular edema is an important cause of visual loss in the developed world and may frequently lead to irreversible changes in visual acuity. The Early Treatment Diabetic Retinopathy Study showed a significant benefit in using focal laser photocoagulation for the treatment of macular edema, more specifically defined as clinically significant macular edema. However, some cases of diabetic macular edema are refracto Read More

Diabetic retinopathy is the leading cause of blindness in developed countries. Diabetic macular edema (DME) is the most frequent cause of vision loss in patients with type 2 diabetes. Steroids may reduce the concentration of inflammatory cytokines and growth factors, and have effect on increased vascular permeability. Topical steroids does not reach intraocular therapeutic concentrations and periocular injection requires Read More

Diabetes mellitus is a growing health concern world-wide. Patients with this disease present with a variety of health conditions, including a number of sight-threatening ocular pathologies. Proliferative diabetic retinopathy (PDR) and diabetic macula edema (DME) are common diseases that cause substantial vision impairment in diabetic patients. There has been a strong focus on studying the epidemiology and treatment of these d Read More

Diabetic retinopathy (DR) remains the major threat to sight in the working age population. Diabetic macular edema (DME) is a manifestation of DR that produces loss of central vision. Macular edema within 1 disk diameter of the fovea is present in 9% of the diabetic population. Proliferative diabetic retinopathy (PDR) is a major cause of visual loss in diabetic patients. In PDR, the growth of new vessels from the retina or optic Read More

Ranibizumab (Lucentis®) is a Fab-Antibody with high affinity for VEGF, and is being designed to bind to all VEGF isoforms. This quality makes it a powerful drug for VEGF inhibition. Diseases of retinal and choroidal blood vessels are the most prevalent causes of moderate and severe vision loss in developed countries. Vascular endothelial growth factor plays a critical role in the pathogenesis of many of these diseases. Results of Read More

Anti-VEGF drugs may be employed in the surgical treatment of diabetic retinopathy. 1. Prior to surgery. The intravitreal injection of anti-VEGF drugs leads to a significant reduction of neovascularization, with a reduction in the adherence of the fibrovascular complex to the retina. This simplifies viscodelamination and reduces intraoperative bleeding during delamination and segmentation. To minimize the risk of tractional retinal Read More

In the absence of posterior vitreous detachment, vitreous cortex is adhered to the internal limiting lamina of the inner retina. This junction between the vitreous and the retina is thought to participate in the pathophysiology of diverse retinal diseases, including proliferative diabetic retinopathy and diabetic macular edema. Vitrectomy has been associated with decrease of macular edema and improvement of visual acuity in eye Read More

This paper reviews the current experience and trends in 23-gauge transconjunctival sutureless vitrectomy for diabetic retinopathy in those patients that need a surgical intervention for either vitreous hemorrhage, fibrovascular proliferation with traction retinal detachment affecting or threatening the macula, traction-rhegmatogenous retinal detachment, or refractory macular edema with taut posterior hyaloid. Since t Read More