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Prog Retin Eye Res. 2016 Mar;51:156-86. doi: 10.1016/j.preteyeres.2015.08.001. Epub 2015 Aug 18.

The progress in understanding and treatment of diabetic retinopathy.

Author information

1
Centre for Experimental Medicine, Queen's University Belfast, Northern Ireland, UK. Electronic address: a.stitt@qub.ac.uk.
2
Centre for Experimental Medicine, Queen's University Belfast, Northern Ireland, UK.
3
Centre for Public Health, Queen's University Belfast, Northern Ireland, UK.
4
Centre for Experimental Medicine, Queen's University Belfast, Northern Ireland, UK; NHMRC Clinical Trials Centre, Sydney Medical School, The University of Sydney, Australia.
5
Department of Medicine and Clinical Chemistry, University of Heidelberg, Heidelberg, Germany.
6
Institut de Recerca Hospital Universitari Vall d'Hebron (VHIR), Barcelona, Spain.

Abstract

Diabetic retinopathy is the most frequently occurring complication of diabetes mellitus and remains a leading cause of vision loss globally. Its aetiology and pathology have been extensively studied for half a century, yet there are disappointingly few therapeutic options. Although some new treatments have been introduced for diabetic macular oedema (DMO) (e.g. intravitreal vascular endothelial growth factor inhibitors ('anti-VEGFs') and new steroids), up to 50% of patients fail to respond. Furthermore, for people with proliferative diabetic retinopathy (PDR), laser photocoagulation remains a mainstay therapy, even though it is an inherently destructive procedure. This review summarises the clinical features of diabetic retinopathy and its risk factors. It describes details of retinal pathology and how advances in our understanding of pathogenesis have led to identification of new therapeutic targets. We emphasise that although there have been significant advances, there is still a pressing need for a better understanding basic mechanisms enable development of reliable and robust means to identify patients at highest risk, and to intervene effectively before vision loss occurs.

KEYWORDS:

Diabetes; Diabetic macular oedema; Diabetic retinopathy; Pathogenesis; Retina

[Indexed for MEDLINE]

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