Refining the treatment parameters of diabetic retinopathy: New prospects and limitations on the horizon

摘要

Macular edema accounts for the large majority of visual impairment and blindness related to diabetic retinopathy, which in turn is not only the most frequent microvascular complication of diabetes, but the most feared one by the persons at risk (Coyne et al., 2004; Klein, Lee, Knudtson, Gangnon, & Klein, 2009). While the diabetologists primarily pay attention to the control of blood glucose and blood pressure, routine screening visits by eye doctors can be used in addition to further motivate patients to get exercise and reduce weight.Ophthalmologists can nowadays frequently use the very effective anti-VEGF drugs for diabetic maculopathy, before respectively while destructive laser photocoagulation is being considered the traditional alternative with a lower visual prognosis (Lang et al., 2013). In order to achieve a significant increase in visual acuity, a regular and frequent administration of ranibizumab - in this case an invasive surgical procedure - is necessary, at least during the first years. There is a growing body of evidence that under-treatment is a key factor limiting the functional gain, which arrives only very slowly and gradually under monthly injections (Brown et al., 2013).