Diabetes mellitus (DM) is a metabolic disorder that develops over time and can be diagnosed at any age. It can also cause systemic problems. Diabetic Retinopathy (DR) is the most significant ocular consequence of diabetes mellitus (DM) and a leading cause of vision loss. Edematous capillary disease is the first symptom of DR, which is followed by ischemic capilaropathy and the beginning of neovascularization by vasoproliferative angiogenic factor. Clinically significant macular edoema, which can occur at any stage of DR and is the most prevalent cause of visual loss in DM, determines the severity of DR. DR develops after more than 15 years of DM progression, a timeframe that provides for the prevention, early detection, and proper treatment of DR with routine diabetic patient monitoring, including clinical control, FO, AFG, and OCT. Regular monitoring of the DM and DR patient according to the type of DM, illness progression, and presence of macular edoema is required for DR preventive treatment, which includes maintaining a glucose level as close to normal as feasible. AntiVEGF agents (vascular, endothelial, growth factor) are indicated in the treatment of macular edoema and therapeutic adjuvant in LP laser to block angiogenesis by inhibiting VEGF; - Laser photocoagulation (LP) is indicated in the phase of pre-proliferative, neovases, duration of diabetes, DR stage, presence of diabetic macular edoema; non-continuous Pascal multispot LP is indicated in the phase of pre Direct focal LP and macular grid LP are the only non-proliferative DR treatments available for macular edoema. The use of a laser to treat macular lesions lowers the chance of vision loss in DR eyes. Panretinal Photocoagulation (PRP) is a proliferative DR treatment (which has more benefits in type 2 DM); where appropriate, laser photocoagulation is paired with anti-VEGF medication to minimise macular edoema. - Surgical treatment – vitrectomy is used to treat DR problems such as in-vitro bleeding and retinal tension separation (RTD). To summarise, DR is a serious DM complication that must be closely monitored, and the patient's long and difficult treatment must be indicated judiciously and carried out with serious care; many patients present late, with eye complications and sometimes signs of low vision or vision loss already present.
Author(S) Details
Marieta Dumitrache
Department of Ophtalmology, “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania.
Rodica Lascu
“Misan Med” Clinic, Sibiu, Romania.
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