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A Journal on Internal Medicine

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Minerva Medica 2003 December;94(6):419-36

language: English

Diabetic retinopathy

Grassi G.


Blindness is one of the most feared complications of diabetes but also one of the most preventable. Diabetic retinopathy (DR) in the way of proliferative retinopathy (PDR) and macular oedema (ME) is the commonest cause of new cases of legal blindness in Europe as in North America in the age group 30 to 70-74 years. DR is due to microangiopathy affecting the retinal precapillary arterioles, capillaries, and venules. Detection of the earliest signs of DR is an essential requirement of diabetics care leading to early preventive and treatment strategies which can arrest progression of this serious consequence of diabetes. Glycemic control and stricter control of hypertension have a clear effect on the development of the microvascular complications of diabetes like DR, while treatment options of severe non proliferative and proliferative forms of DR are limited to laser photocoagulation and vitrectomy. Photocoagulation has proven efficacy in slowing down the progression of DR and vitrectomy can prevent vision loss in case of advanced DR. Older and newer pathogenesis-based approaches to medical treatment are currently under evaluation by randomized controlled clinical studies still with inconclusive results. A review of these studies is proposed.

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