Review article

Diabetic retinopathy – risk factors and treatment

Snježana Kaštelan orcid.org/0000-0002-3983-1157 ; Department for ophtalmological diseases, Klinical hospital Dubrava, Zagreb, Croatia
Martina Tomić ; Department for diabetes complications, Clinics for ophtalmology, University clinics for diabetes, endocrinology and metabolic diseases „Vuk Vrhovac“, Zagreb, Croatia
Višnja Mrazovac ; Clinics for ophtalmological diseases, School of medicine Zagreb, Clinical hospital centre Zagreb, Zagreb, Croatia
Josip Pavan ; Department for ophtalmological diseases, Klinical hospital Dubrava, Zagreb, Croatia
Jasmina Salopek-Rabatić ; Department for ophtalmological diseases, Klinical hospital Dubrava, Zagreb, Croatia
Adrijan Lukenda ; Department for ophtalmological diseases, Klinical hospital Dubrava, Zagreb, Croatia

Abstract

Diabetic retinopathy, the main microvascular complication of diabetes mellitus, is also estimated to be the leading cause of new blindness in the working population of developed countries. The prevalence of retinopathy in both types of diabetes increases with the duration of diabetes and is highly related to hyperglycemia, hypertension, hyperlipidemia, pregnancy, nephropathy and anemia. The most common causes of visual loss in diabetic patients are diabetic maculopathy and proliferative diabetic retinopathy. Therefore, the main goal of treatment in protecting or improving vision in these patients is to reduce vascular leakage and macular edema, retinal ischemia and growth of fragile new vessels. This would in turn prevent vitreous hemorrhages and tractional retinal detachment. The first step in managing diabetic retinopathy is to reduce the risk of retinopathy development and progression by controlling and treating the underlying risk factors. Laser photocoagulation is the primary method of treatment of macular edema and early stages of proliferative diabetic retinopathy, while pars plana vitrectomy is reserved for severe complications such as severe persistent vitreous hemorrhages or/and tractional retinal detachment. However, more recently, many researches have directed their efforts towards better understanding the microvascular changes in diabetic retinopathy in order to develop more effective pharmacologic prevention and treatment, and determine new treatment strategies. The three major classes of agents currently being studied are: corticosteroids, vascular endothelial growth factor antagonists and agents that are involved in biochemical pathways (protein kinase C inhibitors, somatostatine analogue, aldose reductase and advanced glycation end products inhibitors).

Keywords

diabetic retinopathy; prevention; risk factors; treatment

Hrčak ID:

48837

URI

https://hrcak.srce.hr/48837

Publication date:

1.3.2010.

Article data in other languages: croatian

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