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Perspectives

New management paradigms in diabetic retinopathy

Vivek B Pandya, Alex P Hunyor

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Abstract

New approaches to treating diabetic retinopathy have yielded excellent outcomes and continue to be refined. Primary care providers have a key role in optimising medical treatment, co-ordinating care and providing education to improve disease awareness.

Key Points

  • The most important determinants of ocular health in patients with diabetes are early detection, optimisation of blood glucose levels and treatment of associated hypertension.
  • Vision-threatening diabetic retinopathy most commonly refers to diabetic macular oedema (DMO) and/or proliferative diabetic retinopathy (PDR).
  • DMO typically presents gradually, with blurred vision, central distortion and difficulty reading. In contrast, early PDR is often initially asymptomatic and a high index of suspicion is required in patients with poorly controlled diabetes of significant duration.
  • There is now extensive evidence for the safety and superiority of intravitreal anti-vascular endothelial growth factor agents for the treatment of DMO and PDR, with the potential to improve vision in addition to stabilising disease.

    Picture credit: © Scott Bodell.

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