Diabetic Retinopathy - Essay Example

Results from numerous clinical trials of laser photocoagulation and various other treatments and a good understanding of the pathogenesis would have a huge impact on blindness in the diabetic population. [PubMed - indexed for MEDLINE] The prevalence of retinopathy is strongly linked to the duration of diabetes. A stringent control of blood sugar levels delays the onset of diabetes. Vision loss with diabetic retinopathy may occur from several different mechanisms such as Macular oedema or ischemia which may impair central vision.

Extensive studies have reported the cost effectiveness of screening for diabetic retinopathy as it saves vision at reduced costs. The cost of screening modalities depends largely on various factors such as trained professionals and accessibility of screening equipment. Current management of diabetic retinopathy includes systematic control of blood pressure and glucose levels, surgery including laser photocoagulation or pars plana vitrectomy; and currently developed pharmacologic interventions.

Vitrectomy is capable of restoring useful vision to patients suffering from severe diabetic retinopathy and vitreous hemorrhage either with or without an accompanying traction retinal detachment. [PubMed - indexed for MEDLINE]Systemic Control:Development and progression of diabetic retinopathyis delayed by glycemic control. Laser photocoagulation, which represents the only treatment modality in large, controlled, prospective randomized, clinical trials, shows limited efficacy. Currently, new pharmacologic modalities now being evaluated show promise, but should undergo rigorous prospective randomized clinical trial in order to gain widespread acceptance.

Intensive therapy brought down the risk of developing diabetic retinopathy by 76% and reduced the risk of progression of already existing retinopathy by 54%. Maintaining a strict and systematic control of blood pressure and glucose has proven to be difficult for many patients with diabetes. A good number of them will still develop progressive retinopathy and would require either vitrectomy or laser photocoagulation [PubMed - indexed for MEDLINE]Surgery:The latest in surgical techniques is the use of the "Pulse Electron Avalanche Knife" (PEAK-fc, Carl Zeiss Meditec, Jena, Germany) (British Journal of Ophthalmology 2007;91:949-954) which is a new pulsed electrosurgical device that helps in the precise "cold" traction- free tissue dissection.

It is very useful in all complicated eye surgeries.For late stages of retinopathy, current laser or surgical treatments are applicable. It also includes proliferative diabetic retinopathy or sight-threatening ME. The study that was conducted proved that photocoagulation can reduce the risk of severe visual loss by about 50%. [PubMed - indexed for MEDLINE]In this process, laser photocoagulation leads to decreased oxygen levels by the retina due to the destruction of the photoreceptor.Anakinra, which is a drug used in arthritis has tested favorably for reducing blood sugar levels.

Benfotiamine is a fat-soluble form of vitamin B1 has proved effective by reversing the damage done to the retina due to high blood sugar in the cells. Another surgical research is the