Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Apr 15, 2015; 6(3): 489-499
Published online Apr 15, 2015. doi: 10.4239/wjd.v6.i3.489
Diabetic retinopathy - ocular complications of diabetes mellitus
Martin M Nentwich, Michael W Ulbig
Martin M Nentwich, Michael W Ulbig, Department of Ophthalmology, Ludwig-Maximilians University, 80336 Munich, Germany
Author contributions: Nentwich MM and Ulbig MW contributed to this paper.
Conflict-of-interest: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Dr. Martin M Nentwich, Department of Ophthalmology, Ludwig-Maximilians University, Mathildenstr 8, 80336 Munich, Germany.
Telephone: +49-89-440053811 Fax: +49-89-440054569
Received: July 17, 2014
Peer-review started: July 17, 2014
First decision: November 27, 2014
Revised: January 3, 2015
Accepted: January 18, 2015
Article in press: January 20, 2015
Published online: April 15, 2015

In industrialized nations diabetic retinopathy is the most frequent microvascular complication of diabetes mellitus and the most common cause of blindness in the working-age population. In the next 15 years, the number of patients suffering from diabetes mellitus is expected to increase significantly. By the year 2030, about 440 million people in the age-group 20-79 years are estimated to be suffering from diabetes mellitus worldwide (prevalence 7.7%), while in 2010 there were 285 million people with diabetes mellitus (prevalence 6.4%). This accounts for an increase in patients with diabetes in industrialized nations by 20% and in developing countries by 69% until the year 2030. Due to the expected rise in diabetic patients, the need for ophthalmic care of patients (i.e., exams and treatments) will also increase and represents a challenge for eye-care providers. Development of optimized screening programs, which respect available resources of the ophthalmic infrastructure, will become even more important. Main reasons for loss of vision in patients with diabetes mellitus are diabetic macular edema and proliferative diabetic retinopathy. Incidence or progression of these potentially blinding complications can be greatly reduced by adequate control of blood glucose and blood pressure levels. Additionally, regular ophthalmic exams are mandatory for detecting ocular complications and initiating treatments such as laser photocoagulation in case of clinical significant diabetic macular edema or early proliferative diabetic retinopathy. In this way, the risk of blindness can considerably be reduced. In advanced stages of diabetic retinopathy, pars-plana vitrectomy is performed to treat vitreous hemorrhage and tractional retinal detachment. In recent years, the advent of intravitreal medication has improved therapeutic options for patients with advanced diabetic macular edema.

Keywords: Laser photocoagulation, Diabetic macular edema, Diabetic retinopathy, Intravitreal injection, Prevention

Core tip: Diabetic retinopathy is a potentially blinding complication of diabetes mellitus. In patients with diabetes, regular retinal exams are essential. While laser photocoagulation is effective, if performed in time, advanced stages of diabetic retinopathy need to be treated by vitreo-retinal surgery and have limited visual prognosis. Even though new therapeutic options such as intravitreal medical therapy and sutureless pars-plana vitrectomy have improved ophthalmic care of patients with diabetes, interdisciplinary care of these patients is essential. Good metabolic and blood pressure control is indispensable for reducing the risk of ophthalmic complications.