Diabetic Retinopathy

This book addresses diabetic retinopathy, an eye disease that remains one of the main causes of vision loss if not diagnosed and managed properly. It aims to cover the entire spectrum of the disease by describing its clinical identification and characterization, pathophysiology, epidemiology, and medical and surgical management. Diabetic Retinopathy also offers a complete overview of the present understanding of diabetic retinopathy, covering current practice but also including original contributions that offer novel perspectives for looking at and addressing this disease. The author has dedicated his lifetime to the study of diabetic retinal disease and has organized this book around his personal experience but at the same time giving the necessary information for updated management of diabetic retinopathy. Diabetic Retinopathy will be especially useful for postgraduate students in diabetology, retina specialists and researchers. Ch. 1. Standards of medical care in diabetes - 2009 / American Diabetes Association. 1.1. Classification and diagnosis. 1.2. Testing for prediabetes and diabetes in asymptomatic patients. 1.3. Detection and diagnosis of GDM. 1.4. Prevention/delay of type 2 diabetes. 1.5. Diabetes care. 1.6. Prevention and management of diabetes complications -- ch. 2. Clinical presentation of retinopathy / Jose Cunha-Vaz -- ch. 3. Clinical diagnostic methodologies. 3.1. Fundus photography and fluorescein angiography / Lilianne Duarte and Jose Cunha-Vaz. 3.2. Measurements of retinal thickness / Joao Figueira, Rui Bernardes and Jose Cunha-Vaz. 3.3. Vitreous fluorometry and retinal leakage measurements / Jose Cunha-Vaz and Conceicao Lobo. 3.4. Blood flow / Jose Cunha-Vaz. 3.5. Retinal neural impairment / Miguel Castelo-Branco. 3.6. Multimodal macula mapping / Rui Bernardes, Conceicao Lobo and Jose Cunha-Vaz -- ch. 4. Pathogenesis. 4.1. Molecular mechanisms / Paulo Pereira. 4.2. Cell factors / Antonio Francisco Ambrosio. 4.3. Neovascularization in diabetic retinopathy / Ermelindo Leal and Antonio Francisco Ambrosio. 4.4. Candidate genes of diabetic retinopathy / Alda Ambrosio -- ch. 5. Epidemiology / Jose Rui Faria Abreu. 5.1. Prevalence of visual impairment. 5.2. Incidence of visual impairment. 5.3. Risk factors for visual loss. 5.4. Economic costs of visual impairment and blindness. 5.5. Prevalence of retinopathy. 5.6. Risk factors of retinopathy. 5.7. Retinopathy, comorbidity and mortality. 5.8. Health care delivery -- ch. 6. Major clinical trials on treatment for diabetic retinopathy / Luisa Ribeiro. 6.1. Photocoagulation. 6.2. Vitrectomy. 6.3. Medical approaches -- ch. 7. Photocoagulation for macular edema and proliferative retinopathy / Francisco Gomez-Ulla. 7.1. Rationale and results of photocoagulation. 7.2. Clinical evaluation and pre-treatment options. 7.3. Laser treatment techniques. 7.4. Post-operative follow-up and complications. 7.5. Special cases. 7.6. Conclusions and general guidelines -- ch. 8. Vitrectomy for diabetic retinopathy / Jose Carlos Pastor. 8.1. Surgical indications. 8.2. Managing vitrectomy-associated cataracts. 8.3. Surgical objectives and techniques. 8.4. Outcomes and complications of vitrectomy in diabetic retinopathy. 8.5. New instrumentation. 8.6. Conclusions -- ch. 9. Medical management of diabetic retinopathy / Jose Rui Faria Abreu and Jose Cunha-Vaz. 9.1. Glycemic control. 9.2. Blood pressure control. 9.3. Dyslipidemic control. 9.4. Treatment of anemia. 9.5. Experimental therapies -- ch. 10. An integrated perspective on diabetic retinopathy in type 2 diabetes / Jose Cunha-Vaz. 10.1. Limitations of present classifications of nonproliferative diabetic retinopathy. 10.2. Natural history of the initial stages of NPDR. 10.3. Markers of diabetic retinal disease. 10.4. Characterization of retinopathy phenotypes. 10.5. Dominant pathophysiological mechanisms of disease progression. 10.6. Biochemical pathways involved. 10.7. Candidate phenotype/genotype correlations. 10.8. Relevance for clinical trial design. 10.9. Relevance for clinical management. 10.10. Targeted treatments. 10.11. Determining risk in the individual patient. Preventative ophthalmology Standards of medical care in diabetes, 2009 / American Diabetes Association Clinical presentation of retinopathy / José Cunha-Vaz Clinical diagnostic methodologies Pathogenesis Epidemiology / José Rui Faria Abreu Major clinical trials on treatment for diabetic retinopathy / Luisa Ribeiro Photocoagulation for macular edema and proliferative retinopathy / Francisco Goméz-Ulla Vitrectomy for diabetic retinopathy / José Carlos Pastor Medical management of diabetic retinopathy / José Rui Faria Abreu and José Cunha-Vaz An integrated perspective on diabetic retinopathy in type 2 diabetes / José Cunha-Vaz.