Keywords
Prevenção
Monitoramento
Opções Terapêuticas
Controle Glicêmico
How to Cite
Abstract
Diabetic retinopathy is a prevalent and debilitating eye complication associated with diabetes mellitus. This review article addresses prevention measures, monitoring, and therapeutic options for patients with diabetic retinopathy, emphasizing its clinical importance and impact on patients' quality of life. In prevention, strict glycemic control and blood pressure management play central roles in reducing the risk and progression of diabetic retinopathy. Patient education is also crucial in promoting healthy habits. Regular retinal monitoring through fundus photography, optical coherence tomography (OCT), and OCTA angiography enables early detection of retinal changes, allowing for timely interventions. In the field of therapeutic options, intravitreal injections of anti-angiogenics, such as ranibizumab and bevacizumab, have revolutionized the treatment of diabetic macular edema (DME) and improved patients' vision. Therapies based on vascular growth factors, such as aflibercept, offer promising therapeutic alternatives. Managing diabetic retinopathy requires multidisciplinary approaches involving ophthalmologists, endocrinologists, and health educators. Personalizing treatment based on the disease stage and the individual patient's response is essential. Ongoing advances in clinical and technological research offer hope for better control and treatment of diabetic retinopathy, with the goal of preserving vision and enhancing patients' quality of life.
References
AMERICAN DIABETES ASSOCIATION. (2020). STANDARDS OF MEDICAL CARE IN DIABETES—2020. Diabetes Care, 43(Suppl 1), S14-S31.
AWATA T, et al. (2015). A genome-wide association study for diabetic retinopathy in a Japanese population: potential association with a long intergenic non-coding RNA. PLoS One, 10(4), e0118418.
BROWNLEE M. (2005). THE PATHOBIOLOGY OF DIABETIC COMPLICATIONS: A UNIFYING MECHANISM. Diabetes, 54(6), 1615-1625.
CABRERA DEBUC, D., & SOMFAI, G. M. (2018). EARLY DETECTION OF RETINAL THICKNESS CHANGES IN DIABETES USING OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY. PLoS One, 13(1), e0191181.
COLHOUN HM, et al. (2004). PRIMARY PREVENTION OF CARDIOVASCULAR DISEASE WITH ATORVASTATIN IN TYPE 2 DIABETES IN THE COLLABORATIVE ATORVASTATIN DIABETES STUDY (CARDS): MULTICENTRE RANDOMISED PLACEBO-CONTROLLED TRIAL. Lancet, 364(9435), 685-696.
CONLIN, P. R., et al. (2020). TELEMEDICINE FOR DIABETES RETINOPATHY IN URBAN SAFETY-NET CLINICS: A RANDOMIZED CONTROLLED TRIAL. American Journal of Ophthalmology, 216, 209-216.
DAS, A., et al. (2019). ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR AGENTS FOR DIABETIC MACULAR OEDEMA: SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS. The British Journal of Ophthalmology, 103(11), 1547-1553.
DIABETIC RETINOPATHY CLINICAL RESEARCH NETWORK. (2013). A RANDOMIZED TRIAL COMPARING INTRAVITREAL TRIAMCINOLONE ACETONIDE AND FOCAL/GRID PHOTOCOAGULATION FOR DIABETIC MACULAR EDEMA. Ophthalmology, 120(4), 785-794.
DIABETIC RETINOPATHY CLINICAL RESEARCH NETWORK. (2015). AFLIBERCEPT, BEVACIZUMAB, OR RANIBIZUMAB FOR DIABETIC MACULAR EDEMA. New England Journal of Medicine, 372(13), 1193-1203.
DIABETIC RETINOPATHY STUDY RESEARCH GROUP. (1976). PHOTOCOAGULATION TREATMENT OF PROLIFERATIVE DIABETIC RETINOPATHY: CLINICAL APPLICATION OF DIABETIC RETINOPATHY STUDY (DRS) FINDINGS, DRS REPORT NUMBER 8. Ophthalmology, 83(4), 396-406.
FISHER L, et al. (2012). BEHAVIOR MATTERS. The Diabetes Educator, 38(5), 619-628.
HALLER JA, et al. (2015). RANDOMIZED TRIAL OF PERIBULBAR TRIAMCINOLONE ACETONIDE WITH AND WITHOUT FOCAL PHOTOCOAGULATION FOR MILD DIABETIC MACULAR EDEMA: A PILOT STUDY. Ophthalmology, 122(11), 2262-2271.
HAMMES, H. P., et al. (2011). DIABETIC RETINOPATHY: TARGETING VASOREGRESSION. Diabetes, 60(1), 9-16.
HWANG, T. S., et al. (2015). OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY FEATURES OF DIABETIC RETINOPATHY. Retina, 35(11), 2371-2376.
KLEIN BE, et al. (2009). SERUM LIPIDS AND PROLIFERATIVE DIABETIC RETINOPATHY AND MACULAR EDEMA IN PERSONS WITH LONG-TERM TYPE 1 DIABETES MELLITUS: THE WISCONSIN EPIDEMIOLOGIC STUDY OF DIABETIC RETINOPATHY. JAMA Ophthalmology, 127(3), 309-316.
KOZAK, I., et al. (2013). ULTRA-HIGH RESOLUTION SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY IN PATIENTS WITH DECREASED VISUAL ACUITY DURING FOLLOW-UP AFTER RETINAL LASER PHOTOCOAGULATION. The British Journal of Ophthalmology, 97(2), 201-206.
SIVAPRASAD S, et al. (2020). ASSOCIATION OF INTRAVITREAL AFLIBERCEPT WITH OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY VESSEL DENSITY IN PATIENTS WITH PROLIFERATIVE DIABETIC RETINOPATHY. JAMA Ophthalmology, 138(7), 685-690.
STRATTON IM, et al. (2000). ASSOCIATION OF GLYCAEMIA WITH MACROVASCULAR AND MICROVASCULAR COMPLICATIONS OF TYPE 2 DIABETES (UKPDS 35): PROSPECTIVE OBSERVATIONAL STUDY. BMJ, 321(7258), 405-412.
UK PROSPECTIVE DIABETES STUDY GROUP. (1998). TIGHT BLOOD PRESSURE CONTROL AND RISK OF MACROVASCULAR AND MICROVASCULAR COMPLICATIONS IN TYPE 2 DIABETES: UKPDS 38. BMJ, 317(7160), 703-713.
WELLS JA, et al. (2019). AFLIBERCEPT, BEVACIZUMAB, OR RANIBIZUMAB FOR DIABETIC MACULAR EDEMA: TWO-YEAR RESULTS FROM A COMPARATIVE EFFECTIVENESS RANDOMIZED CLINICAL TRIAL. Ophthalmology, 126(10), 1356-1366.
WILKINSON, C. P., et al. (2003). PROPOSED INTERNATIONAL CLINICAL DIABETIC RETINOPATHY AND DIABETIC MACULAR EDEMA DISEASE SEVERITY SCALES. Ophthalmology, 110(9), 1677-1682.
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