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Middle East African Journal of Ophthalmology Middle East African Journal of Ophthalmology
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DIABETIC RETINOPATHY UPDATE
Year : 2013  |  Volume : 20  |  Issue : 4  |  Page : 273-282

Evolving strategies in the management of diabetic retinopathy


Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia

Correspondence Address:
Ahmed M Abu El-Asrar
Department of Ophthalmology, King Abdulaziz University Hospital, Old Airport Road, P.O. Box 245, Riyadh 11411
Saudi Arabia
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Source of Support: Medical Research Chair funded by Dr. Nasser Al.Rasheed (AMA), Conflict of Interest: None


DOI: 10.4103/0974-9233.119993

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Diabetic retinopathy (DR), the most common long-term complication of diabetes mellitus, remains one of the leading causes of blindness worldwide. Tight glycemic and blood pressure control has been shown to significantly decrease the risk of development as well as the progression of retinopathy and represents the cornerstone of medical management of DR. The two most threatening complications of DR are diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR). Focal/grid photocoagulation and panretinal photocoagulation are standard treatments for both DME and PDR, respectively. Focal/grid photocoagulation is a better treatment than intravitreal triamcinolone acetonide in eyes with DME. Currently, most experts consider combination focal/grid laser therapy and pharmacotherapy with intravitreal antivascular endothelial growth factor agents in patients with center-involving DME. Combination therapy reduces the frequency of injections needed to control edema. Vitrectomy with removal of the posterior hyaloid seems to be effective in eyes with persistent diffuse DME, particularly in eyes with associated vitreomacular traction. Emerging therapies include fenofibrate, ruboxistaurin, renin-angiotensin system blockers, peroxisome proliferator-activated receptor gamma agonists, pharmacologic vitreolysis, and islet cell transplantation.


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