Diabetic retinopathy represents microvascular end-organ damage as a result of diabetes. It ranges from non-proliferative diabetic retinopathy (NPDR) and its stages to proliferative diabetic retinopathy (PDR). As the disease progresses, associated diabetic macular edema (DME ) may also become apparent.
Among patients aged 25-74, diabetic retinopathy is a leading cause of vision loss worldwide. By 2030 an estimated 191.0 million people globally will have diabetic retinopathy, and approximately 56.3 million will have vision-threatening diabetic retinopathy. The Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) Cohort showed that after 20 years of diabetes mellitus, 99% of patients with type 1 and 60% of patients with type 2 show some degree of retinopathy. There are several other key risk factors for the developments of diabetic retinopathy beyond years since diagnosis and type of diabetes. Additionally, elevated hemoglobin A1C levels and blood pressure are associated with increased risk of diabetic retinopathy.
Symptoms of decreased vision or fluctuating vision, presence of floaters (vitreous hemorrhage) or defects in the field of vision.
Systemic control of diabetes, hypertension, hyperlipidemia, hypercholesterolemia, nephropathy and other diseases are of paramount importance.
Treatment of macular edema is usually needed in order to prevent loss of vision or to try to improve vision. Treatment includes the use of lasers or injection of drugs that cause the retinal swelling/macular edema (from leaking blood vessels) to resolve. Patients are seen monthly if being injected or every 3 months post-laser for macular edema.