Document Detail


Medical management of diabetic retinopathy: an overview.
MedLine Citation:
PMID:  23020540     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Diabetes mellitus is a global health problem affecting 366 million people worldwide and its prevalence is growing rapidly. Diabetic eye disease is present in up to 25% of diabetic subjects. Diabetic retinopathy is a chronic complication of diabetes that can result in blindness. Generally, there are two stages of diabetic retinopathy, non-proliferative and proliferative. The longer a person has diabetes and the poorer metabolic control, the higher the chance of developing diabetic retinopathy. The majority of people with type 2 diabetes will ultimately develop diabetic retinopathy.  Multifactorial therapy targeted to lifestyle modification and optional glycemic control reduces the risk. However, diabetic retinopathy develops or progresses with time.  Primary (preventive) strategies include glycemic, lipid, and blood pressure control.  Glycemic control effectively reduces the incidence of diabetic retinopathy. In additional, its effect on progression of diabetic retinopathy has been demonstrated in randomized clinical trials.  Furthermore, tight control of blood pressure significantly reduces the progression of retinopathy and visual loss. However, the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye Study Group has shown that intensive blood pressure control has no beneficial effect on reducing the rate of diabetic retinopathy in subjects with type 2 diabetes.  Elevated serum lipids and dyslipidemias are associated with a higher risk of diabetic retinopathy. The beneficial effects of lipid-lowering agents on the progression of retinopathy have been reported. Intensive combination therapy for dyslipidemia has been shown to effectively reduce the rate of progression of diabetic retinopathy in type 2 diabetes.  Secondary strategies are focused on various pathophysiologic approaches such as blockade of the renin angiotensin system (RAS), anti-vascular endothelial growth factor agents, somatostatin analogues, protein kinase inhibitors, and anti-inflammatory agents.  The purpose of the current overview is to look into the medical management of diabetic retinopathy, and to explore the primary (preventive) measures as well as secondary strategies proposed to be effective in its medical management.
Authors:
Mojtaba Malek; Mohammad E Khamseh; Rokhsareh Aghili; Zahra Emami; Laily Najafi; Hamid R Baradaran
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Archives of Iranian medicine     Volume:  15     ISSN:  1735-3947     ISO Abbreviation:  Arch Iran Med     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-01     Completed Date:  2013-02-04     Revised Date:  2013-05-15    
Medline Journal Info:
Nlm Unique ID:  100889644     Medline TA:  Arch Iran Med     Country:  Iran    
Other Details:
Languages:  eng     Pagination:  635-40     Citation Subset:  IM    
Affiliation:
Endocrine Research Center (Firouzgar), Institute of Endocrinology and Metabolism, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
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MeSH Terms
Descriptor/Qualifier:
Angiotensin II Type 1 Receptor Blockers / therapeutic use
Angiotensin-Converting Enzyme Inhibitors / therapeutic use
Anti-Inflammatory Agents / therapeutic use
Antioxidants / therapeutic use
Diabetic Retinopathy / prevention & control*
Diagnostic Techniques, Ophthalmological
Dyslipidemias / prevention & control
Humans
Hypertension / prevention & control
Hypolipidemic Agents / therapeutic use
Primary Prevention
Protein Kinase C / antagonists & inhibitors
Risk Factors
Secondary Prevention
Somatostatin / analogs & derivatives
Vascular Endothelial Growth Factor A / antagonists & inhibitors
Chemical
Reg. No./Substance:
0/Angiotensin II Type 1 Receptor Blockers; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Anti-Inflammatory Agents; 0/Antioxidants; 0/Hypolipidemic Agents; 0/Vascular Endothelial Growth Factor A; 51110-01-1/Somatostatin; EC 2.7.11.13/Protein Kinase C

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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