Perpective on diabetic retinopathy

Purpoe To review the evolution of the undertanding of diabetic retinopathy (DR) and method of treating DR, the preent clinically relevant practice for eye dieae in patient with diabete mellitu, and trend in clinical patient care over the next 3 to 5 year. Deign Tabular review and preentation of clinical trial contributing to the undertanding and treatment of DR and the author’ philoophy of care for the patient with diabete. Reult Diabetic retinopathy i a microvacular complication of diabete mellitu that i a ignificant caue of new-onet blindne. The Diabetic Retinopathy tudy wa the firt multicentered, randomized, clinical trial in ophthalmology. Thi tudy provided the cientific evidence for treatment of DR with catter (panretinal) photocoagulation, and led to the funding of other multicentered clinical trial, including the Early Treatment Diabetic Retinopathy tudy, which greatly elucidated the natural hitory of DR and firmly etablihed laer photocoagulation a treatment for proliferative diabetic retinopathy (PDR) and diabetic macular edema. The Diabete Control and Complication Trial and United Kingdom Propective Diabete tudy etablihed the value of intenive glycemic control in reducing the rik of onet and progreion of DR and other microvacualr complication of diabete. Concluion evere viion lo and moderate viion lo from diabete are eentially preventable with timely detection and treatment, careful long-term follow-up and comprehenive diabete mellitu care firmly baed on clinical evidence. Future treatment, a outgrowth of further undertanding of the biochemical bai of the dieae, will aim at curing or preventing retinal complication from diabete.