Diabetic retinopathy 2: Treatment of diabetic retinopathy and diabetic macular oedema
Authors:
Mária Molnárová
Authors‘ workplace:
II. očná klinika SZU, NsP F. D. Roosevelta, Banská Bystrica
Published in:
Forum Diab 2012; 1(2-3): 97-103
Category:
Overview
Treatment of diabetic retinopathy and diabetic macular oedema is based on the new knowledge in the pathogenesis of the disease. Treatment of DR and DEM has two levels: 1st level: good glycaemic control, which was confirmed by conclusions of clinical trials: Wisconsin Epidemiologic Study of Diabetic Retinopathy, Diabetes Control and Complications Trial, Diabetes Intervention and Complications Study and United Kingdom Prospective Diabetes Study, 2nd level: treatment of DR and DEM: lasercoagulation, intravitreal pharmacological therapy or surgical therapy. Clinical studies ETDRS, DRS, DRCR.net, RESTORE, RESOLVE, READ 1, READ 2, Macugen Diabetic Retinopathy Study Group and Da Vinci showed that visual acuity on treated eyes with lasercoagulation of DEM and DR stabilizes, in the intravitreal treatment in 50 % of patients can be significantly improved.
Key words:
diabetic retinopathy – diabetic macular oedema – good glycaemic control – laser therapy – intravitreal pharmacological therapy – surgical therapy
Sources
1. Browning DJ. Diabetic Retinopathy, Evidence-Based Management. New York, Heidelberg, London: Springer Science & Business Media 2010. ISBN 978–0–387–85899–9.
2. Diabetes Control and Complication Trial research group. Progression of retinopathy with intensive versus conventional treatment in the diabetes control and complications trial. Ophthalmology 1995; 102(4): 647–661.
3. UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylurea or insulin compared with conventional treatment and risk of complications in patients type 2 diabetes (UKPDS 33). Lancet 1998; 352(9131): 837–853.
4. Klein R, Knudtson MD, Lee KE et al. The Wisconsin epidemiologic study of diabetic retinopathy XXII. The twenty-five-year progression of retinopathy in persons with type 1 diabetes. Ophthalmology 2008; 115(11): 1859–1868.
5. The Writing Team for The Diabetes Control and Complications Trial/ Epidemiology of Diabetes Interventions an Complications research group. Effect of Intensive therapy on the microvascular complications of type 1 diabetes mellitus. JAMA 2002; 287(19): 2563–2569.
6. The Diabetes Control and Complications Trial Research Group. The relationship of glycaemic exposure (HbA1c) to the risk of development and progression of retinopathy in the diabetes control and complications trial. Diabetes 1995; 44(8): 968–983.
7. The Diabetes Control and Complications Trial. Epidemiology of Diabetes Interventions and Complications Research group. Prolonged effect of intensive therapy on the risk of retinopathy comlications in patients with type 1 diabetes mellitus: 10 years after the diabetes control and complications trial. Arch Ophthalmol 1995; 113(1): 36–51.
8. Do DV, Shah SM, Sung JU et al. Persistent diabetic macular oedema is associated with elevated hemoglobin A1c. Am J Ophthalmol 2005; 139(4): 620–623.
9. Early Treatment Diabetic Retinopathy Study Research Group. Photocoagulation for diabetic macular oedema. Arch Ophthalmol 1985; 103(12): 1796–1806.
10. Gangnon R, Hubbard LD, Aiello LP et al. A severity scale for diabetic macular oedema developed from ETDRS data. Invest Ophthalmol Vis Sci 2008; 49(11): 5041–5047.
11. Browning DJ, Fraser CM. The predictive value of patient and eye characteristics on the course of subclinical diabetic macular edema? Am J Ophthalmol 2008; 145(1): 149–154.
12. Diabetic Retinopathy Clinical Research Network. A randomized trial comparing intravitreal triamcinolon acetonide and focal/grid photocoagulation for diabetic macular edema. Ophthalmology 2008; 115(9): 1447–1459.
13. Olk RJ, Wallow IH, Poulsen GL. Argon green (514) versus krypton red (647) modified grid laser photocoagulation for diffuse diabetic macular oedema. Ophthalmology 1990; 97(9): 1101–1113.
14. Larsen ML, Moeller F, Sander B et al. Subthreshold micropulse diode laser treatment in diabetic macular oedema? Br J Ophthalmol 2004; 88(9): 1173–1179.
15. Jonas JB, Sofker A. Intraocular injection of crystalline cortisone as adjunctive treatment for diabetic macular edema. Am J Ophthalmol 2001; 132(3): 425–427.
16. Roh MI, Bycon SH, Kwon OW. Repeated intravitreal injection of bevacizumab for clinically significant diabetic macular oedema. Retina 2008; 28(9): 1314–1318.
17. The Diabetic Retinopathy Clinical Research Network. Randomized Trial Evaluating Ranibizumab Plus Prompt or Deferred Laser or Triamcinolone Plus Prompt Laser for Diabetic Macular Edema. Fort Lauderdale. Ophthalmology 2010; 117(6): 1064–1077.
18. Lang GE. Laser treatment of diabetic retinopathy. Dev Ophthalmol 2007; 39: 48–68.
19. Kotoula MG, Koukoulis GN, Zintzaras E et al. Metabolic control of diabetes is associated with an improved response of diabetic retinopathy to panretinal photocogalation. Diabetes Care 2005; 28(10): 2454–2457.
20. Fujio N, Feke GT, Goger DG, McMeel JW. Regional retinal blood flowreduction following half fundus photocoagulation treatment. Br J Ophthalmol 1994; 78(5): 335–338.
21. Remky A, Arend O, Beausencourt E et al. Retinal vessel before and after photocoagulation in diabetic retinopathy. Determining the diameter using digitized color fundus slides. Klin Monatsbl Augenheilkd 1996; 209(8–9): 79–83.
22. Early Treatment Diabetic Retinopathy Study Research Group. Early photocoagulation for diabetic retinopathy. ETDRS report number 9. Ophthalmology 1991; 98(Suppl 5): 766–785.
23. Early Treatment Diabetic Retinopathy Study Research Group. Fundus photographic risk factors for progression of diabetic retinopathy. ETDRS report number 12. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology 1991; 98(Suppl 5): 823–833.
24. Wu WC, Hsu KH, Chen TL et al. Interventions for relieving pain associated with panretinal photocoagulation a prospective randomized trial. Eye 2006; 20(6): 712–719.
25. Schwartz SG, Flynn HW jr. Pharmacotherapies for diabetic retinopathy: present and future. Exp Diabetes Res 2007; 2007: 52487. Dostupný z WWW(DOI): http://doi: 10.1155/2007/52487
26. Flynn HW jr, Chew EY, Simons BD et al. Pars plana vitrectomy in the Early Treatment Diabetic Retinopathy Study. ETDRS report number 17. The Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology 1992; 99(9): 1351–1357.
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