A Holistic Approach To Diabetic Retinopathy

Threatening Diabetic Retinopathy (DR) is projected to nearly triple in the next forty years1. DR is predominantly a microangiopathy in which small blood vessels are particularly vulnerable to damage from high glucose levels. Direct hyperglycemic effects along with many angiogenic stimulators (like vascular endothelial growth factor) and inhibitors have a role to play in the causation of DR. A consistent screening with timely metabolic control helps prevent ocular disease in diabetic patients, thereby decreasing the need for intravitreal anti-VEGFs and steroids, laser photocoagulation and vitrectomy with or without epiretinal membrane removal or peeling of internal limiting membrane. Therefore, a tight regulation of blood glucose, blood pressure, serum lipids, albuminuria (signifying diabetic nephropathy), anemia is important. Additional risk factors that need to be taken care of include- smoking in males with type1 diabetes, puberty, pregnancy, duration of disease.