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Diabetic Retinopathy Guidelines

Diabetic Retinopathy Clinical Practice Guidelines: Customized For Iranian Population Rajavi Z, Safi S, Javadi Ma, Azarmina M, Moradian S, Entezari M, Nourinia R, Ahmadieh H, Shirvani A, Shahraz S, Ramezani A, Dehghan Mh, Shahsavari M, Soheilian M, Nikkhah H, Ziaei H, Behboudi H, Farrahi F, Falavarjani Kg, Parvaresh Mm, Fesharaki H, Abrishami M, Shoeibi N, Rahimi M, Javadzadeh A, Karkhaneh R, Riazi-esfahani M, Manaviat Mr, Maleki A, Kheiri B, Golbafian F - J Ophthalmic Vis Res

Diabetic Retinopathy Clinical Practice Guidelines: Customized For Iranian Population Rajavi Z, Safi S, Javadi Ma, Azarmina M, Moradian S, Entezari M, Nourinia R, Ahmadieh H, Shirvani A, Shahraz S, Ramezani A, Dehghan Mh, Shahsavari M, Soheilian M, Nikkhah H, Ziaei H, Behboudi H, Farrahi F, Falavarjani Kg, Parvaresh Mm, Fesharaki H, Abrishami M, Shoeibi N, Rahimi M, Javadzadeh A, Karkhaneh R, Riazi-esfahani M, Manaviat Mr, Maleki A, Kheiri B, Golbafian F - J Ophthalmic Vis Res

Nanditha A, Ma RC, Ramachandran A, Snehalatha C, Chan JC, Chia KS, et al. Diabetes in Asia and the Pacific: Implications for the global epidemic. Diabetes Care 2016;39:472-485. Shaw JE, Sicree RA, Zimmet PZ. Global estimates of the prevalence of diabetes for 2010 and 2030. Diabetes Res Clin Pract 2010;87:4-14. Prevention of blindness from diabetes mellitus: report of a WHO consultation in Geneva, Switzerland, 9-11 November 2005. Available from: . [Last accessed on 2015 Dec 27]. Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Global estimates of diabetes prevalence for 2013 and projections for 2035. Diabetes Res Clin Pract 2014;103:137-49. International Diabetes Federation. IDF Diabetes Atlas. 6 th ed., 2015. Available from: attachments/?task=download & id=116. [Last accessed on 2016 Jan 25]. Esteghamati A, Gouya MM, Abbasi M, Delavari A, Alikhani S, Alaedini F, et al. Prevalence of diabetes and impaired fasting glucose in the adult population of Iran: National survey of risk factors for non-communicable diseases of Iran. Diabetes Care 2008;31:96-98. Hadaegh F, Bozorgmanesh MR, Ghasemi A, Harati H, Saadat N, Azizi F. High prevalence of undiagnosed diabetes and abnormal glucose tolerance in the Iranian urban population: Tehran Lipid and Glucose Study. BMC Public Health 2008;8:176. Jones S, Edwards RT. Diabetic retinopathy screening: A systematic review of the economic evidence. Diabet Med 2010;27:249-256. Yau JW, Rogers SL, Kawasaki R, Lamoureux EL, Kowalski JW, Bek T, et al. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care 2012;35:556-564. Katibeh M, Pakravan M, Yaseri M, Pakbin M, Soleimanizad R. Prevalence and causes of visual impairment and blindness in central Iran; The Yazd Eye Study. J Ophthalmic Vis Res 2015 Continue reading >>

Diabetic Retinopathy: Updated Guidelines Reflect Improved Assessment And Treatment

Diabetic Retinopathy: Updated Guidelines Reflect Improved Assessment And Treatment

Diabetic Retinopathy: Updated Guidelines Reflect Improved Assessment and Treatment The American Diabetes Association (ADA) released their first position statement in 15 years regarding diabetic retinopathy. The updated statement reflects the significant advancements made in both assessment and treatment of the condition since ADAs last guidance in 2002. The report notes the recent improvements made in evaluating the diabetes complication, such as the implementation of optical coherence tomography for assessing retinal thickness and intraretinal pathology, and wide-field fundus photography to detect clinically silent microvascular lesions. Therapies have also made advancements, with treatment now given by intravitreous injection of anti-vascular endothelial growth factor (VEGF) agents. Treatment recommendations from the ADA include: Promptly refer patients with any level of macular edema, severe nonproliferative diabetic retinopathy, or any proliferative diabetic retinopathy to an ophthalmologist. Laser photocoagulation therapy reduces risk of vision loss in patients with high-risk proliferative diabetic retinopathy and, in some cases, severe nonproliferative diabetic retinopathy. Intravitreous injections of anti-vascular endothelial growth factor are indicated for central-involved diabetic macular edema. The presence of retinopathy is not a contraindication to aspirin therapy for cardioprotection, as aspirin does not increase the risk of retinal hemorrhage. The ADA recommends optimization of glycemic control, as well as blood pressure and serum lipids, to reduce or slow the progression of diabetic retinopathy. The report also advises screening via dilated and comprehensive eye exam by an eye specialist within 5 years after the onset of type 1 diabetes and immediately a Continue reading >>

Diabetic Retinopathy Management Guidelines

Diabetic Retinopathy Management Guidelines

Diabetic Retinopathy Management Guidelines Diabetic retinopathy (DR) is an important cause of avoidable blindness worldwide. Seventy percent of diabetes occur in low and lower-middle income countries. Clinical practice guidelines for the management of DR have been implemented throughout the world, but mainly in developed nations. However, there is considerable variation between existing guidelines in the recommended frequency of referral, methods for examination and personnel involved in screening and review. This review compares the differences between current available guidelines in the context of the current medical evidence and also addresses the implications for management of DR in countries with limited resources. Clinical practice guidelines are defined as 'systematically developed statements' that assist practitioners in making appropriate decisions for healthcare for specific clinical circumstances.[ 1 ] Guidelines are now commonly developed and used for a variety of medical specialties including ophthalmology. Traditionally, guidelines were based on consensus among experts. However, this does not necessarily represent current medical knowledge. Therefore, the paradigm for guideline development has shifted towards systematic identification and appraisal of the best available evidence. The main purpose of clinical guidelines is to better health outcomes through improving practice of health professionals. The process of development and implementation of guidelines is a major undertaking, requiring contribution from individuals and groups in a multidisciplinary approach to ensure that consensus is achieved to make the guidelines work effectively. Diabetic retinopathy (DR) is a microvascular complication of diabetes. Research has clearly demonstrated that blindnes Continue reading >>

My Site - Chapter 30: Retinopathy

My Site - Chapter 30: Retinopathy

Laser therapy, local intraocular pharmacological therapy and surgery reduce the risk of significant visual loss. Diabetic retinopathy is the most common cause of new cases of legal blindness in people of working age (1) . The Eye Diseases Prevalence Research Group determined the crude prevalence rate of retinopathy in the adult population with diabetes of the United States to be 40.3%; sight-threatening retinopathy occurred at a rate of 8.2% (1) . Previous data showed the prevalence rate of proliferative retinopathy to be 23% in people with type 1 diabetes, 14% in people with type 2 diabetes and on insulin therapy, and 3% in people receiving oral antihyperglycemic therapies (2) . Macular edema occurs in 11%, 15% and 4% of these groups, respectively (3) . Higher prevalence rates were noted in First Nations populations in Canada (4,5) . Visual loss is associated with significant morbidity, including increased falls, hip fracture and a 4-fold increase in mortality (6) . Among individuals with type 1 diabetes, limb amputation and visual loss due to diabetic retinopathy are the independent predictors of early death (7) . Diabetic retinopathy is clinically defined, diagnosed and treated based on the extent of retinal vascular disease exclusively. Three distinct forms of diabetic retinopathy are described: 1) macular edema, which includes diffuse or focal vascular leakage at the macula; 2) progressive accumulation of blood vessel change that includes microaneurysms, intraretinal hemorrhage, vascular tortuosity and vascular malformation (together known as nonproliferative diabetic retinopathy) that ultimately leads to abnormal vessel growth (proliferative diabetic retinopathy); and 3) retinal capillary closure, a form of vascular change detected on fluorescein angiography, whi Continue reading >>

Keep Your Eye On The New Diabetic Retinopathy Guidelines

Keep Your Eye On The New Diabetic Retinopathy Guidelines

Keep your Eye on the new Diabetic Retinopathy Guidelines Daisy, a 67-year-old woman with Type 2 diabetes, presents to your clinic with her daughter Skye (age 23) and her grandson Forrest, 9, who both have Type 1 diabetes. All three of them received a diagnosis of diabetes on November 1, the day after Halloween. At what age do you recommend screening for diabetic retinopathy, and how often do you recommend screening, for Skye is planning to begin conception of a second child. What do you recommend regarding diabetic retinopathy screening? Daisy read on her local seniors' Facebook group about the importance of antioxidants and asks if these are recommended for diabetic retinopathy. What do you reply? The Canadian Ophthalmological Society has released 2017 guidelines for primary care providers regarding screening for diabetic retinopathy. Here are some highlights: TYPE 1 - START at puberty. If diagnosed after puberty, start 5 years after diagnosis. 1) If considering pregnancy, get ophthalmic evaluation before attempting to conceive 2) Recommend Teleophthalmology for rural and remote patients (if available) 3) High-dose Antioxidant use is NOT helpful at preventing retinopathy Finally,KNOW and TREAT Risk factorsfor diabetic retinopathy: *Interestingly the evidence shows that every 2 years is OK - however the recommendation remains to screen every 1-2 years for fear of poor adherence. **Treatment has not convincingly been shown to reduce retinopathy, but consider treating to reduce cardiovascular risk if they meet lipid guideline recommendations - see the summary table from the 2016 Canadian guidelines here Excerpt from the Canadian Ophthalmological Society evidence-based clinical practice guidelines for the management of diabetic retinopathy. Can J Ophthalmol. 52(S1), 2017. Continue reading >>

Contemporary Management Of Diabetic Retinopathy In Canada: From Guidelines To Algorithm Guidance

Contemporary Management Of Diabetic Retinopathy In Canada: From Guidelines To Algorithm Guidance

Contemporary Management of Diabetic Retinopathy in Canada: From Guidelines to Algorithm Guidance Hooper P.a Boucher M.-C.b Colleaux K.c Cruess A.d Greve M.e Lam W.-C.f Shortt S.g Tourville E.h I have read the Karger Terms and Conditions and agree. I have read the Karger Terms and Conditions and agree. Buy a Karger Article Bundle (KAB) and profit from a discount! If you would like to redeem your KAB credit, please log in . Save over 20% compared to the individual article price. Buy Cloud Access for unlimited viewing via different devices Access to all articles of the subscribed year(s) guaranteed for 5 years Unlimited re-access via Subscriber Login or MyKarger Unrestricted printing, no saving restrictions for personal use * The final prices may differ from the prices shown due to specifics of VAT rules. For additional information: Recent advances in the therapeutic options and approaches for diabetic retinopathy (DR) and diabetic macular edema (DME) have resulted in improved visual outcomes for many patients with diabetes. Yet, they have also created many clinical dilemmas for treating ophthalmologists and retina specialists, including treatment selection, initiation, frequency and duration. With this in mind, a panel of Canadian retina specialists met and discussed the current clinical evidence as well as specific situations and scenarios commonly encountered in daily practice. They also shared their experiences and therapeutic approaches. This document, containing a consensus on treatment algorithms for various clinical scenarios, is the result of their lengthy and in-depth discussions and considerations. The intent is to provide a step-by-step approach to the treatment of DR and DME. Although clinicians are encouraged to use and refer to these algorithms as a guide f Continue reading >>

When Should Screening For Diabetic Retinopathy Begin For Children With Type 1 Diabetes?

When Should Screening For Diabetic Retinopathy Begin For Children With Type 1 Diabetes?

When should screening for diabetic retinopathy begin for children with type 1 diabetes? Accepted author version posted online: 22 Jan 2016 Click to increase image sizeClick to decrease image size Visual impairment and blindness as a result of diabetic retinopathy (DR) are amongst the most feared complications of diabetes. However, the prevalence of sight-threatening diabetic retinopathy (STDR) has been slowly decreasing[ 1 Hovind P, Tarnow L, Rossing K, et al. Decreasing incidence of severe diabetic microangiopathy in type 1 diabetes. Diabetes Care. 2003;26(4):12581264. [Crossref] , [PubMed] , [Web of Science ] , [Google Scholar] 4 Romero-Aroca P, Fernndez-Balart J, Baget-Bernaldiz M, et al. Changes in the diabetic retinopathy epidemiology after 14 years in a population of type 1 and 2 diabetic patients after the new diabetes mellitus diagnosis criteria and a more strict control of the patients. J Diabetes Complications. 2009;23(4):229238. [Crossref] , [PubMed] , [Web of Science ] , [Google Scholar] ]. Recently, it has been reported that diabetes is no longer the leading cause of blindness in the working age population in the United Kingdom[ 5 Liew G, Michaelides M, Bunce C. A comparison of the causes of blindness certifications in England and Wales in working age adults (16-64 years), 1999-2000 with 2009-2010. BMJ Open. 2014;4(2):e004015-e004015. [Crossref] , [Web of Science ] , [Google Scholar] ]. These observations may reflect the cumulative impact of better management of diabetes, the introduction of screening programs aiming to identify STDR, and more active and effective ophthalmologic management. Good glycemic and blood pressure control are pivotal in the primary prevention of DR, with some evidence of direct benefit from fibrates when used in those with dyslipi Continue reading >>

American Diabetes Association Issues Diabetic Retinopathy Position Statement

American Diabetes Association Issues Diabetic Retinopathy Position Statement

American Diabetes Association Issues Diabetic Retinopathy Position Statement Updated recommendations include new diagnostic technology and treatment guidelines Diabetes affects the entire body and can result in long-term complications, including damage to the small blood vessels. Such damage can lead to problems in the retina of the eye, a condition known as diabetic retinopathy. The American Diabetes Association (Association) has issued updated guidelines on prevention, assessment and treatment of diabetic retinopathy for providers and for people with diabetes. The detailed recommendations are featured in the article, "Diabetic Retinopathy: A Position Statement by the American Diabetes Association," to be published in the March 2017 issue of Diabetes Care , and online on February 21, 2017. The position statement includes information on advancements in diabetic retinopathy assessment and treatment methods, as well as improvements in managing diabetes that have developed since its prior diabetic retinopathy position statement in 2002. New diagnostic developments include the widespread adoption of optical coherence tomography, as well as intraretinal pathology and wide-eld fundus photography. Newer treatment modalities, including intravitreous injection of antivascular endothelial growth factor agents, are also outlined in the statement. "Diabetic retinopathy is actually the most common cause of new cases of blindness in adults who live in developed countries and are between the ages of 20 and 74," said Thomas W. Gardner, MD, MS, corresponding author of the article and professor of ophthalmology and visual sciences at the Kellogg Eye Center at the University of Michigan."Over the past decade, new research and significant improvements in technology have aided our ability Continue reading >>

Ada Updates Treatment And Screening Guidelines For Diabetic Retinopathy

Ada Updates Treatment And Screening Guidelines For Diabetic Retinopathy

ADA Updates Treatment and Screening Guidelines for Diabetic Retinopathy The American Diabetes Association has released new guidelines for the diagnostic assessment and treatment of diabetic retinopathy . The guidelines incorporate improvements in treatment and testing options for diabetic retinopathy since the publication of the American Diabetes Association Statement in 2002. These improvements include the widespread adoption of optical coherence tomography to assess retinal thickness and intraretinal pathology and wide-field fundus photography to reveal clinically silent microvascular lesions, the guidelines stated. ______________________________________________________________________________________________________________________________________________________________________ ______________________________________________________________________________________________________________________________________________________________________ Blood pressure, lipid, and glycemic control are strongly recommended to reduce the risk or slow the progression of diabetic retinopathy. If retinopathy is not present in one or more annual eye exams, then screening every 2 years may be considered for the patient. Retinal photography is recommended as a screening tool but not as a replacement for comprehensive eye exams. Patients with type 2 diabetes should have a comprehensive eye exam at the time of diagnosis. Patients with type 1 diabetes should have a comprehensive eye exam within 5 years after onset of diabetes. In addition, the recommendations include treatments for diabetic macular edema, proliferative diabetic retinopathy, and recommendations for screening women with type 1 or type 2 diabetes who are pregnant or want to become pregnant. Solomon SD, Chew E, Duh EJ, et al. Continue reading >>

Diabetic Retinopathy Ppp - Updated 2017

Diabetic Retinopathy Ppp - Updated 2017

HIGHLIGHTED FINDINGS AND RECOMMENDATIONS FOR CARE The prevalence of diabetes, both worldwide and in the United States, is increasing; as such, the prevalence of diabetic retinopathy and vision-threatening diabetic retinopathy (VTDR) is also expected to increase dramatically. Currently, only about 60% of people with diabetes have yearly screenings for diabetic retinopathy. People with Type 1 diabetes should have annual screenings for diabetic retinopathy beginning 5 years after the onset of their disease, whereas those with Type 2 diabetes should have a prompt examination at the time of diagnosis and at least yearly examinations thereafter. Maintaining near-normal glucose levels and near-normal blood pressure lowers the risk of retinopathy developing and/or progressing, so patients should be informed of the importance of maintaining good glycosylated hemoglobin levels, serum lipids, and blood pressure. Patients with diabetes may use aspirin for other medical indications without an adverse effect on their risk of diabetic retinopathy. Women who develop gestational diabetes do not require an eye examination during pregnancy and do not appear to be at increased risk of developing diabetic retinopathy during pregnancy. However, patients with diabetes who become pregnant should be examined early in the course of the pregnancy. Referral to an ophthalmologist is required when there is any nonproliferative diabetic retinopathy, proliferative retinopathy, or macular edema. Ophthalmologists should communicate both ophthalmologic findings and level of retinopathy to the primary care physician. They should emphasize to the patient the need to adhere to the primary care physicians guidance to optimize metabolic control. Intravitreal injections of anti-vascular endothelial growth fac Continue reading >>

Chua Eye Page: Guidelines For Diabetic Retinopathy

Chua Eye Page: Guidelines For Diabetic Retinopathy

AmericanAcademy of Ophthalmology Guidelines for Diabetic Retinopathy Diabetic retinopathy remains themajor sight threatening eye disease in the working age population, in thedeveloped world. The WHO/IDF (Europe) has endorsed the St. Vincent Declaration(1990) which embodied the aim of reducing the prevalence of visual handicapby one third by the year 20001. Although physicians and ophthalmologistsare actively engaged in applying effective therapies to various forms ofretinopathy, there is still disagreement concerning many aspects of thepractical management of diabetic patients with retinopathy. These guidelinesrepresent a consensus document outlining the epidemiology, clinical featuresand treatment of various forms of diabetic retinopathy. In addition, informationon risk factors and screening methods for retinopathy is included. Somespecial problems are discussed in the latter part of the document as wellas aspects of counselling for patients at different stages of the disease.The Guidelines are advisory and are not intended as a set of rigid rules,since individual patients will require tailored treatment for their particularcondition. However, it is hoped that if used appropriately, they will leadto uniformity in the best management of patients with diabetic retinopathy. Continue reading >>

Update On Diagnosis And Treatment Of Diabetic Retinopathy: A Consensus Guideline Of The Working Group Of Ocular Health (spanish Society Of Diabetes And Spanish Vitreous And Retina Society)

Update On Diagnosis And Treatment Of Diabetic Retinopathy: A Consensus Guideline Of The Working Group Of Ocular Health (spanish Society Of Diabetes And Spanish Vitreous And Retina Society)

Update on Diagnosis and Treatment of Diabetic Retinopathy: A Consensus Guideline of the Working Group of Ocular Health (Spanish Society of Diabetes and Spanish Vitreous and Retina Society) 1Spanish Retina and Vitreous Society (SERV), IMO (Institut Microcirurgia Ocular), Barcelona, Spain 2Spanish Society of Diabetes (SED), Endocrinology Department, Valme University Hospital and RAMSE Foundation, Sevilla, Spain 3Spanish Society of Diabetes (SED), Endocrinology and Nutrition Department, Hospital General Universitario Gregorio Maran, Madrid, Spain 4Spanish Society of Diabetes (SED), Diabetes and Metabolism Research Unit and CIBERDEM (ISCIII), Vall dHebron Reseach Institute (VHIR), Barcelona, Spain 5Spanish Retina and Vitreous Society (SERV), Department of Ophthalmology, Castilla La Mancha University, Albacete, Spain 6University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain 7Spanish Society of Diabetes (SED), Department of Endocrinology and Nutrition, University Clinic of Navarra, Pamplona, Spain 8Spanish Retina and Vitreous Society (SERV), Department of Ophthalmology, Nuevo Hospital Univeristario y Politcnico La Fe, Valencia, Spain Correspondence should be addressed to Rafael Sim Received 30 December 2016; Revised 20 April 2017; Accepted 23 May 2017; Published 14 June 2017 Copyright 2017 Borja Corcstegui et al. This is an open access article distributed under the Creative Commons Attribution License , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. A group of members of the Spanish Retina and Vitreous Society (SERV) and of the Working Group of Ocular Health of the Spanish Society of Diabetes (SED) updated knowledge regarding the diagnosis and treatment of diabetic retinopathy (DR) based on r Continue reading >>

The Royal College Of Ophthalmologists' Clinical Guidelines For Diabetic Retinopathy: A Summary

The Royal College Of Ophthalmologists' Clinical Guidelines For Diabetic Retinopathy: A Summary

The Royal College of Ophthalmologists' clinical guidelines for diabetic retinopathy: a summary F Ghanchi 1,* and the Diabetic Retinopathy Guidelines Working Group*,2 1Bradford Teaching Hospitals, Bradford, UK *Bradford Teaching Hospitals, Duckworth Lane, Bradford BD9 6RJ, UK. E-mail: [email protected] 2The members of the Diabetic Retinopathy Guidelines Working Group who participated are listed at the end of the article. Ghanchi F, Bailey C, Chakravarthy U, Cohen S, Dodson P, Gibson J, Menon G, Muqit M, Pilling R, Olson J, Prasad S, Scanlon P, Stanga P, Vafidis G, Wright A and Wykes W. Copyright 2013 Royal College of Ophthalmologists This article has been cited by other articles in PMC. Incidence of diabetes mellitus (DM) is increasing globally. Around 90% of the burden is caused by type II diabetes, a preventable chronic disease. Approximately 4.56% of the UK population is diabetic, totalling just under 1.4 m. The incidence of both type I and type II diabetes is on the rise. Diabetic retinopathy (DR) is a microvascular complication of DM. Both the duration of diabetes and glycaemic control are independent risk factors for severity and progression of DR. DR is more prevalent in older age groups with long-standing disease. Many studies exist on diabetic eye disease in different parts of the world, all of which provide a picture of increasing concern with respect to the prevalence of this disorder. The burden of retinopathy is significant, certain epidemiological characteristics are documented. Younger-onset group of diabetic patients have twice more prevalence of proliferative diabetic retinopathy (PDR) compared with the older-onset group that takes insulin. The 10-year incidence of macular oedema is reportedly two-fold higher in insulin-dependent diabetic pop Continue reading >>

Diabetic Retinopathy

Diabetic Retinopathy

What Is Diabetic Retinopathy? Diabetic retinopathy is the most common eye disease caused by the various forms of diabetes: Type 1: The body does not produce insulin in Type 1 diabetes, usually diagnosed in children and young adults and previously called juvenile diabetes. Type 2: Over time, insulin production stops or the body’s cells ignore it. Gestational: Blood sugar levels become elevated during some pregnancies. All forms of diabetes may result in damage to the blood vessels in the retina, which is a delicate structure lining the inside back wall of your eye. The retina is responsible for detecting light which is then transmitted via the optic nerve to your brain. The brain then interprets this light as images. The damaged blood vessels can blur vision, severely limit it or even destroy it completely as the disease progresses. Our team can help you manage your diabetes, then provide top treatments if diabetic retinopathy takes hold. Learn more about other eye problems tied to diabetes: Stanford Diabetic Retinopathy Expertise One of the main challenges with diabetic retinopathy is knowing when to treat it, then recommending which approach to use. We can help you with these decisions, by offering: Top doctors: Our doctors have extensive training and experience treating diabetic retinopathy. Guidelines for the condition change quickly—not only do our doctors track the latest findings closely, they also conduct their own leading research. New advances: We offer the latest diagnostic and treatment options and are developing more. We pioneered PASCAL laser therapy. Our OCT angiography looks at blood flow without injecting dye. And we are studying longer-lasting injections and improved lasers with clinical trials. Coordinated care: Diabetes affects the whole body, not Continue reading >>

[national Guidelines For Treatment Of Diabetic Retinopathy : Second Edition Of The National Guidelines For Treatment Of Diabetic Retinopathy].

[national Guidelines For Treatment Of Diabetic Retinopathy : Second Edition Of The National Guidelines For Treatment Of Diabetic Retinopathy].

Generate a file for use with external citation management software. Ophthalmologe. 2016 Jul;113(7):623-38. doi: 10.1007/s00347-016-0315-8. [National guidelines for treatment of diabetic retinopathy : Second edition of the national guidelines for treatment of diabetic retinopathy]. Department fr Augenheilkunde, Eberhards-Karl-Universitt Tbingen, Schleichstr.12, 72076, Tbingen, Deutschland. [email protected] Medizinische Klinik, Universittsmedizin Mannheim, Mannheim, Deutschland. Klinik fr Augenheilkunde, Albert-Ludwigs-University Freiburg, Freiburg, Deutschland. The updated German clinical practice guidelines (second edition) describe the consensus recommendations for prevention and treatment of retinal complications secondary to diabetes. According to the updated numbers on epidemiology a further increase of persons affected is expected. The prevalence of diabetic retinopathy is estimated to be 9-16 % in type 2 diabetes and 24-27 % in type 1 diabetes. A prolongation of the screening interval from 1 to 2 years is recommended for those patients with a lower risk of progression, when retinopathy has not already occurred and no increased systemic risk factors are present. Standardized documentation forms are the foundation for improved communication between the disciplines. If diabetic retinopathy is present, control examinations follow the stipulations of the ophthalmologist. The guidelines define scenarios when the use of optical coherence tomography (OCT) is necessary, e. g. diagnosis and follow-up of macular edema. Besides focal and panretinal laser therapy, the efficacy and risks of intravitreal operative pharmacotherapy are discussed. Focal laser coagulation is recommended for therapy of macular edema without foveal involvement and for macular edem Continue reading >>

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