Abstract
Diabetic retinopathy and macular edema are still the most common causes of blindness in the working-aged population. Thus it is important to be familiar with the evidence-based treatment methods available. Laser coagulation is the treatment of choice in the case of clinically significant focal, diabetic macular edema (focal application) and of proliferative diabetic retinopathy (panretinal ...
Abstract
Diabetic retinopathy and macular edema are still the most common causes of blindness in the working-aged population. Thus it is important to be familiar with the evidence-based treatment methods available. Laser coagulation is the treatment of choice in the case of clinically significant focal, diabetic macular edema (focal application) and of proliferative diabetic retinopathy (panretinal application) Panretinal laser coagulation is also an option in the case of severe non-proliferative diabetic retinopathy, when risk factors such as poor compliance, suboptimal glycemic or blood pressure control, among other factors, are present. The value of vitreoretinal surgery is undisputed in the case of advanced diabetic retinopathy with non-resorbent severe vitreous or subhyaloid hemorrhage or vitreoretinal traction with relatively fresh or imminent macular detachment. Only adequate intraoperative panretinal laser coagulation can prevent post-operative complications as a result of retinal ischemia, such as recurrent hemorrhage, retinal detachment or rubeotic secondary glaucoma. Functional results of therapy, however, depend on the extent of ischemic damage to the retina caused by underlying microangiopathy, underlining the necessity for optimal prevention and adequate screening, as well as prompt initiation of therapy.
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