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The evolution of diabetic retinopathy

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Summary

At present photocoagulation affords essentially palliative treatment which has been demonstrated to be effective in reducing blindness in diabetic maculopathy and proliferative retinopathy.

It is only by understanding the evolution of diabetic microangiopathy that effective preventative treatment can be found in the future.

Diabetic retino-microangiopathy is a result of the diabetic state which can be divided into a pre-clinical and clinical stage. In the former various changes occur in the retinal capillaries which include dilation, increased blood flow, breakdown of blood-retinal barrier, basement membrane thickening and loss of pericytes. Finally, capillary closure occurs and the condition becomes clinical when microaneurysms form at the edge of non-perfused areas in the retina. Retinal capillary closure appears to result from abnormality both of the vessel wall and the blood flowing through the vessel. The clinical stage of diabetic retinopathy can be sub-divided into (i) mild background retinopathy, (ii) background retinopathy with maculopathy, (iii) proliferative retinopathy-uncomplicated and (iv) proliferative retinopathy with complications (advanced diabetic eye disease). It is essential to concentrate on the pre-clinical stage of diabetic retinopathy when the condition can be arrested or possibly even reversed.

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  1. Hammersmith Hospital and Moorfields Eye Hospital, London

    Eva M. Kohner (Consultant Physician)

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  1. Eva M. Kohner
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Kohner, E.M. The evolution of diabetic retinopathy. IJMS 148 (Suppl 2), 28–37 (1979). https://doi.org/10.1007/BF02938137

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