Diabetic retinopathy occurs in 40% of patients with diabetes mellitus. It usually affects the central retina, called the macula or the periphery. It occurs more often in patients with type 1 diabetes rather than type 2.
The main method of diagnosing the condition is with dilated fundus exam. Many auxiliary imaging tests are now at our disposal to facilitate the diagnosis.
It is a good practice to take annual photographs of the fundus of the eyes to monitor and stage the disease. We also routinely perform macular OCT to screen for diabetic macular edema, as well as fluorescein angiography when we suspect proliferative diabetic retinopathy.
The treatment depends on the stage of the retinopathy and ranges from simple monitoring to emergency surgery.
Macular disease is now primarily treated with repeated use of intravitreal anti-VEGF injections with very good results. Complementary laser treatment in several cases is necessary. Especially in proliferative diabetic retinopathy pan retinal laser photocoagulation is very important in managing the disease.
Vitreous hemorrhage combined with tractional retinal detachment is a relatively urgent situation which frequently requires surgery.