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EDITORIAL
Year : 2014  |  Volume : 2  |  Issue : 1  |  Page : 1-2

Diabetic retinopathy update


Department of Ophthalmology, Gloucestershire Hospitals, NHS Foundation Trust, Gloucester, United Kingdom

Date of Web Publication3-Mar-2015

Correspondence Address:
Dr. Ahmed Sallam
Department of Ophthalmology, Gloucestershire Hospitals, NHS Foundation Trust, Gloucester
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2347-5617.152476

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How to cite this article:
Sallam A. Diabetic retinopathy update. Egypt Retina J 2014;2:1-2

How to cite this URL:
Sallam A. Diabetic retinopathy update. Egypt Retina J [serial online] 2014 [cited 2020 Apr 5];2:1-2. Available from: http://www.egyptretinaj.com/text.asp?2014/2/1/1/152476

Diabetes mellitus affects an estimated 4% of the worldwide population. [1] Diabetic retinopathy (DR) affects about one-half of patients with diabetes and is one of the leading causes of vision loss and blindness among working-age people. [2] This special edition from Egyptian Retina Journal focuses on the update in the management of DR and maculopathy.

Diabetic retinopathy screening has proved over the years to be effective in reducing the morbidity from DR in countries that adopted this strategy. [3],[4] There are different methods of screening ranging from fundus examination by ophthalmologists to fundus photography and images grading by nonmedical screeners. The article by Professor Scanlon et al., a world renowned UK expert in this field, and his colleagues from Australia, on diabetic screening is a welcome addition to the existing literature on this subject. [5]

Theodoropoulou and Sallam [6] provide an update on the current management of diabetic maculopathy. Recently, argon laser photocoagulation has been the mainstay of treatment for macular edema since the publication of the results of the early treatment DR study, which showed an approximate 50% reduction in the rate of moderate vision loss at 3 years following laser photocoagulation compared to no treatment. However, for patients with center-involving macular edema, the risk of moderate vision loss at 3 years remained 15% with treatment and a very small number of patients gains vision. [7] Within the last 5 years, the use of intravitreal corticosteroids and intravitreal anti-vascular endothelial growth factor (VEGF) agents have come into play in the management of DMO and several recent clinical trials have shown superior effectiveness of these therapeutics compared to conventional macular laser. [8],[9]

The article but Fletcher and Alkherdhaji [10] focuses on the role of anti-VEGF treatment in proliferative diabetic retinopathy (PDR). While panretinal photocoagulation (PRP) remains the gold standard treatment for treatment in PDR, management paradigm is now changing to include the use of anti-VEGF agents in conjunction with PRP in order to improve efficacy and reduce side-effects associated with laser.

The recent advancements in retina imaging and the development of multiple modalities with higher resolution and wider field imaging capabilities have revolutionized our understanding of the pathogenesis of DR and maculopathy, allowed standardized grading as well as early diagnosis and treatment. This is the subject of the article "ocular imaging in DR" by Mohamed. [11]

In addition to screening and medical treatment of DR and maculopathy, this issue of ERJ also covers the surgical aspect of the DR management. Cataract surgery in diabetic patients may results in poor visual outcomes due to the progression of DR and accelerated development of DMO. [12] The article by Dr. Hammam [13] focuses on the prophylaxis and treatment of adverse events, which may limit the visual outcomes after cataract surgery in diabetic patients.

Tractional retinal detachment in DR remains an important cause for severe visual loss. This problem is even worse in developing countries being linked to poor control of diabetes and the lack of structured screening programs for DR. In his article titled "The surgical management of DR complications: An update," Dr. El-Sabagh [14] draws on his experience in diabetic vitrectomy surgery and reviews the recent advancement in vitrectomy techniques, instrumentations and illumination systems.

Finally, I would like to thank our expert authors for taking the time and effort to write the review articles in this special issue of Egyptian Retina Journal. I am also grateful to our readers for their continuous support and encouragement.

 
  References Top

1.
Scott I, Flynn HW, Smiddy WE. Diabetes and Ocular Disease. American Academy of Ophthalmology Monograph Series. Oxford, United Kingdom: Oxford University Press; 2009.  Back to cited text no. 1
    
2.
Evans J. Causes of Blindness and Partial Sightedness in England and Wales 1990-1991. London: Office of Population, Censuses and Surveys; 1995. p. 1-29.  Back to cited text no. 2
    
3.
Scanlon PH. The English national screening programme for sight-threatening diabetic retinopathy. J Med Screen 2008;15:1-4.  Back to cited text no. 3
    
4.
Zoega GM, Gunnarsdóttir T, Björnsdóttir S, Hreietharsson AB, Viggósson G, Stefánsson E. Screening compliance and visual outcome in diabetes. Acta Ophthalmol Scand 2005;83:687-90.  Back to cited text no. 4
    
5.
Scanlon PH, Dirani M, van Wijngaarden P. Screening for sight-threatening diabetic retinopathy: An update. Egypt Retina J 2014;2:3-18.  Back to cited text no. 5
  Medknow Journal  
6.
Theodoropoulou SA, Sallam A. Current trends in the treatment of diabetic macular edema. Egypt Retina J 2014;2:26-34.  Back to cited text no. 6
  Medknow Journal  
7.
Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Early Treatment Diabetic Retinopathy Study research group. Arch Ophthalmol 1985;103:1796-806.  Back to cited text no. 7
    
8.
Mitchell P, Bandello F, Schmidt-Erfurth U, Lang GE, Massin P, Schlingemann RO, et al. The RESTORE study: Ranibizumab monotherapy or combined with laser versus laser monotherapy for diabetic macular edema. Ophthalmology 2011;118:615-25.  Back to cited text no. 8
    
9.
Campochiaro PA, Brown DM, Pearson A, Ciulla T, Boyer D, Holz FG, et al. Long-term benefit of sustained-delivery fluocinolone acetonide vitreous inserts for diabetic macular edema. Ophthalmology 2011;118:626-35.e2.  Back to cited text no. 9
    
10.
Fletcher EC, Alkherdhaji F. Proliferative diabetic retinopathy and the use of anti-vascular endothelial growth factors agents. Egypt Retina J 2014;2:35-40.  Back to cited text no. 10
  Medknow Journal  
11.
Mohamed Q. Ocular imaging in diabetic retinopathy. Egypt Retina J 2014;2:25-19.  Back to cited text no. 11
    
12.
Stein JD, Grossman DS, Mundy KM, Sugar A, Sloan FA. Severe adverse events after cataract surgery among medicare beneficiaries. Ophthalmology 2011;118:1716-23.  Back to cited text no. 12
    
13.
Hammam T. Cataract surgery in diabetic patients. Egypt Retina J 2014;2:55-61.  Back to cited text no. 13
  Medknow Journal  
14.
El-Sabagh HA. The surgical management of diabetic retinopathy complications: An update. Egypt Retina J 2014;2:41-54.  Back to cited text no. 14
  Medknow Journal  




 

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