Optimal treatment of diabetic retinopathy

Diabetic retinopathy (DRP) is a common complication caused by multiple biochemical abnormalities of the underlying metabolic disease. While the incidence of DRP appears to decline due to evidence-based changes in diabetes management, the predicted increase in patients affected in particular by type...

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Main Author: Hans-Peter Hammes
Format: Article
Language:English
Published: SAGE Publishing 2013-04-01
Series:Therapeutic Advances in Endocrinology and Metabolism
Online Access:https://doi.org/10.1177/2042018813477886
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author Hans-Peter Hammes
author_facet Hans-Peter Hammes
author_sort Hans-Peter Hammes
collection DOAJ
description Diabetic retinopathy (DRP) is a common complication caused by multiple biochemical abnormalities of the underlying metabolic disease. While the incidence of DRP appears to decline due to evidence-based changes in diabetes management, the predicted increase in patients affected in particular by type 2 diabetes may outweigh the positive trend. The diagnosis is based on the alterations of the vessels, usually indicating abnormalities of the blood–retinal barrier and increased vasoregression, but the neuroglial elements appear equally vulnerable to the diabetic condition. Control of blood glucose, blood pressure and timely identification of coincident nephropathy are important to prevent progression to vision-threatening stages. Guidelines give specific indications for laser photocoagulation, in particular when euglycemia is no longer effective in preventing progression to advanced stages. Intravitreal administration of antibodies directed against the single best characterized propagator of clinically significant macular edema, vascular endothelial growth factor (VEGF), has become popular despite uncertainty about the patient subgroups which benefit best and the optimum administration schedule. Multifactorial intervention beyond glycemic control includes antihypertensive, lipid-lowering and antiaggregatory and is effective in type 2 diabetic patients with high-risk profiles, in particular coincident nephropathy.
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spelling doaj.art-5c182043775549c49edb9f65ed7a7b5a2022-12-21T20:17:26ZengSAGE PublishingTherapeutic Advances in Endocrinology and Metabolism2042-01882042-01962013-04-01410.1177/2042018813477886Optimal treatment of diabetic retinopathyHans-Peter HammesDiabetic retinopathy (DRP) is a common complication caused by multiple biochemical abnormalities of the underlying metabolic disease. While the incidence of DRP appears to decline due to evidence-based changes in diabetes management, the predicted increase in patients affected in particular by type 2 diabetes may outweigh the positive trend. The diagnosis is based on the alterations of the vessels, usually indicating abnormalities of the blood–retinal barrier and increased vasoregression, but the neuroglial elements appear equally vulnerable to the diabetic condition. Control of blood glucose, blood pressure and timely identification of coincident nephropathy are important to prevent progression to vision-threatening stages. Guidelines give specific indications for laser photocoagulation, in particular when euglycemia is no longer effective in preventing progression to advanced stages. Intravitreal administration of antibodies directed against the single best characterized propagator of clinically significant macular edema, vascular endothelial growth factor (VEGF), has become popular despite uncertainty about the patient subgroups which benefit best and the optimum administration schedule. Multifactorial intervention beyond glycemic control includes antihypertensive, lipid-lowering and antiaggregatory and is effective in type 2 diabetic patients with high-risk profiles, in particular coincident nephropathy.https://doi.org/10.1177/2042018813477886
spellingShingle Hans-Peter Hammes
Optimal treatment of diabetic retinopathy
Therapeutic Advances in Endocrinology and Metabolism
title Optimal treatment of diabetic retinopathy
title_full Optimal treatment of diabetic retinopathy
title_fullStr Optimal treatment of diabetic retinopathy
title_full_unstemmed Optimal treatment of diabetic retinopathy
title_short Optimal treatment of diabetic retinopathy
title_sort optimal treatment of diabetic retinopathy
url https://doi.org/10.1177/2042018813477886
work_keys_str_mv AT hanspeterhammes optimaltreatmentofdiabeticretinopathy