Management of Complications and Vision Loss from Proliferative Diabetic Retinopathy

Curr Diab Rep. 2021 Sep 3;21(9):33. doi: 10.1007/s11892-021-01396-2.

Abstract

Purpose of review: Diabetes can be associated with profound visual loss due to several mechanisms. As the duration of diabetes and blood glucose levels increase, these changes become more severe. The proliferation of new blood vessels, vitreous hemorrhage, and tractional retinal detachments may ultimately result and can be devastating to visual function. New advances, including anti-vascular endothelial growth factor (VEGF) medications and innovative microsurgical instruments, have provided additional methods for the management of diabetic retinopathy in the clinic and in the operating room, leading to improved outcomes.

Recent findings: Advances in earlier treatment of proliferative diabetic retinopathy, especially with anti-VEGF injections, allow for a reduction in severity, improved vision, and more controlled and successful surgery. Modern surgical techniques and instrumentation have also allowed for improved patient outcomes. Future research into sustained delivery and release of anti-VEGF, reducing the need for frequent in-office injections, may prove to be additionally beneficial. Over the last decade, anti-VEGF has become an increasingly common treatment modality for the management of proliferative diabetic retinopathy, vitreous hemorrhages, and tractional retinal detachments. Further research is needed to determine the ideal method of delivery and timing of the treatment.

Keywords: Anti-VEGF; Panretinal photocoagulation; Proliferative diabetic retinopathy; Traction retinal detachment; Vitreous hemorrhage.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Diabetes Mellitus*
  • Diabetic Retinopathy* / drug therapy
  • Diabetic Retinopathy* / surgery
  • Humans
  • Retinal Detachment*
  • Vision Disorders
  • Vitrectomy
  • Vitreous Hemorrhage / surgery