REVIEW  EMERGING ISSUES ON DIABETIC RETINOPATHY AND DIABETIC MACULAR EDEMA 

Minerva Oftalmologica 2018 June;60(2):36-52

DOI: 10.23736/S0026-4903.18.01792-0

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Role of imaging on diagnosis and treatment of diabetic retinopathy

Mariacristina PARRAVANO ✉, Daniele DE GERONIMO

G.B. Bietti Foundation and Institute for Research and Care, Rome, Italy

Diabetic retinopathy (DR) is the leading cause of blindness among working aged individuals in the developed world and its prevalence increases with increasing duration of the disease. The imaging of the fundus of patients with DR through standard methods such as color photography and Fluorescein Angiography has always been a cornerstone in the management and treatment of diabetic patients allowing respectively to monitor and highlight typical diabetic vascular changes such as microaneurysms, hemorrhages, macular edema, exudates, ischemic changes and new vessels. Diabetic macular edema, in particular, is a major contributor to vision loss among patients with DR. More than 25 years ago, the Early Treatment of Diabetic Retinopathy Study (ETDRS) established guidelines for identifying clinically significant macular edema. Optical coherence tomography (OCT) in the modern age has allowed to redefine the approach to diabetic maculopathy allowing to obtain much more informations regarding the quantitative and qualitative features of the macular edema. Recently new techniques such as ultrawide-field imaging and OCT-angiography have enabled many new information to be obtained from the study of the fundus of diabetic patients, which could lead to a new way of managing DR in the near future. Other imaging methods that are not routinely used for imaging of patients with DR, such as retromode or autofluorescence, as well as functional test such as microperimetry, may, however, add useful information in the clinical assessment of the patient.

KEY WORDS: Diabetic retinopathy - Diagnostic imaging - Optical coherence tomography - Angiography