Zusammenfassung
Diabetes mellitus verursacht diabetische Retinopathie, diabetisches Makulaödem, optische Neuropathie, Katarakt und Fehlfunktionen der äusseren Augenmuskeln. Die Inzidenz dieser Spätschäden korreliert mit der Dauer des Diabetes und mit dem Grad der metabolischen Kontrolle. Die Empfehlungen der Österreichischen Diabetesgesellschaft für Diagnose, Therapie und Nachkontrolle werden übersichtsweise und bezogen auf die jeweiligen Stadien der diabetischen Augenerkrankung präsentiert.
Summary
Diabetes mellitus causes diabetic retinopathy, diabetic macular edema, optic neuropathy, cataract or dysfunction of the eye muscles. The incidence of these defects correlates with disease duration and quality of the metabolic control. The recommendations of the Austrian Diabetes Association for the diagnosis, the therapeutic procedures and requirements for adequate follow up depending on the stages of the different forms of diabetic eye disease are summarized.
Literatur
Khadem J, Buzney S, Alich K. Practice patterns in diabetic retinopathy: part 1: analysis of retinopathy follow-up. Arch Ophthalmol. 1999;117(6):815–20.
McCarty C, Taylor K, McKay R, et al. Diabetic retinopathy: effects of national guidelines on the referral, examination and treatment practices of ophthalmologists and optometrists. Clin Experiment Ophthalmol. 2001;29(2):52–8.
Wilkinson C, Ferris F, Klein R, et al. Proposed international clinical diabetic retinopathy and diabetic macular edema disease severity scales. Ophthalmology. 2003;110(9):1677–82.
Hazin R, Colyer M, Lum F, et al. Revisiting Diabetes 2000: challenges in establishing nationwide diabetic retinopathy prevention programs. Am J Ophthalmol. 2011;152(5):723–9. Epub 2011/09/16.
Hammes H, Lemmen K. Diagnostik, Therapie und Verlaufskontrolle der diabetischen Retinopathie und Makulopathie. Diabetes und Stoffwechsel. 2002;11(Suppl 2):15–6.
Klein R, Klein BE, Moss SE. Epidemiology of proliferative diabetic retinopathy. Diabetes Care. 1992;15(12):1875–91.
Klein R, Klein BE, Moss SE, et al. The Wisconsin epidemiologic study of diabetic retinopathy. II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 yrs. Arch Ophthalmol. 1984;102(4):520–6.
Moss SE, Klein R, Klein BE. The incidence of vision loss in a diabetic population. Ophthalmology. 1988;95(10):1340–8.
Zhang L, Krzentowski G, Albert A, et al. Risk of developing retinopathy in Diabetes Control and Complications Trial type 1 diabetic patients with good or poor metabolic control. Diabetes Care. 2001;24(7):1275–9.
Stratton I, Kohner E, Aldington S, et al. UKPDS 50: risk factors for incidence and progression of retinopathy in Type II diabetes over 6 yrs from diagnosis. Diabetologia. 2001;44(2):156–63.
Murphy RP, Nanda M, Plotnick L, et al. The relationship of puberty to diabetic retinopathy. Arch Ophthalmol. 1990;108(2):215–8.
Effect of pregnancy on microvascular complications in the diabetes control and complications trial. The Diabetes Control and Complications Trial Research Group. Diabetes Care. 2000;23(8):1084–91.
Early worsening of diabetic retinopathy in the Diabetes Control and Complications Trial. Arch Ophthalmol. 1998;116(7):874–86.
Orchard T, Forrest K, Kuller L, et al. Lipid and blood pressure treatment goals for type 1 diabetes: 10-year incidence data from the Pittsburgh Epidemiology of Diabetes Complications Study. Diabetes Care. 2001;24(6):1053–9.
Sen K, Misra A, Kumar A, et al. Simvastatin retards progression of retinopathy in diabetic patients with hypercholesterolemia. Diabetes Res Clin Pract. 2002;56(1):1–11.
The absence of a glycemic threshold for the development of long-term complications: the perspective of the Diabetes Control and Complications Trial. Diabetes. 1996;45(10):1289–98.
Klein R, Klein BE, Moss SE, et al. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. XV. The long-term incidence of macular edema. Ophthalmology. 1995;102(1):7–16.
Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38. UK Prospective Diabetes Study Group. BMJ. 1998;317(7160):703–13.
Nasr C, Hoogwerf B, Faiman C, et al. United Kingdom Prospective Diabetes Study (UKPDS). Effects of glucose and blood pressure control on complications of type 2 diabetes mellitus. Cleve Clin J Med. 1999;66(4):247–53.
Davis M, Fisher M, Gangnon R, et al. Risk factors for high-risk proliferative diabetic retinopathy and severe visual loss: Early Treatment Diabetic Retinopathy Study Report Number 18. Invest Ophthalmol Vis Sci. 1998;39(2):233–52.
Case reports to accompany Early Treatment Diabetic Retinopathy Study Reports 3 and 4. The Early Treatment Diabetic Retinopathy Study Research Group. Int Ophthalmol Clin. 1987;27(4):273–333.
Fundus photographic risk factors for progression of diabetic retinopathy. ETDRS report number 12. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology. 1991;5(1):823–33.
Lindgren G, Lindblom B. Causes of vitreous hemorrhage. Curr Opin Ophthalmol. 1996;7(3):13–9.
Fong D, Ferris F, Davis M, et al. Causes of severe visual loss in the early treatment diabetic retinopathy study: ETDRS report no. 24. Early Treatment Diabetic Retinopathy Study Research Group. Am J Ophthalmol. 1999;127(2):137–41.
Scott I, Flynn H, Hughes J. Echographic evaluation of a patient with diabetes and dense vitreous hemorrhage: an avulsed retinal vessel may mimic a tractional retinal detachment. Am J Ophthalmol. 2001;131(4):515–6.
Flynn HJ, Chew EY, Simons BD, et al. Pars plana vitrectomy in the Early Treatment Diabetic Retinopathy Study. ETDRS report number 17. The Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology. 1992;99(9):1351–7.
Hamanaka T, Akabane N, Yajima T, et al. Retinal ischemia and angle neovascularization in proliferative diabetic retinopathy. Am J Ophthalmol. 2001;132(5):648–58.
Antcliff R, Marshall J. The pathogenesis of edema in diabetic maculopathy. Semin Ophthalmol. 1999;14(4):223–32.
Cost-effectiveness of intensive glycemic control, intensified hypertension control, and serum cholesterol level reduction for type 2 diabetes. JAMA. 2002;287(19):2542–51.
Treatment techniques and clinical guidelines for photocoagulation of diabetic macular edema. Early Treatment Diabetic Retinopathy Study Report Number 2. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology. 1987;94(7):761–74.
Kinyoun J, Barton F, Fisher M, et al. Detection of diabetic macular edema. Ophthalmoscopy versus photography--Early Treatment Diabetic Retinopathy Study Report Number 5. The ETDRS Research Group. Ophthalmology. 1989;96(6):746–50.
Gonzalez Villalpando C, Gonzalez Villalpando ME, Martinez Diaz S, et al. A diabetic retinopathy screening program as a strategy for blindness prevention. Arch Med Res. 1997;28(1):129–35.
Pandit RJ, Taylor R. Quality assurance in screening for sight-threatening diabetic retinopathy. Diabet Med. 2002;19(4):285–91.
Kuo HK, Hsieh HH, Liu RT. Screening for diabetic retinopathy by one-field, non-mydriatic, 45 degrees digital photography is inadequate. Ophthalmologica. 2005;219(5):292–6.
Leese GP, Ellis JD, Morris AD, et al. Does direct ophthalmoscopy improve retinal screening for diabetic eye disease by retinal photography? Diabet Med. 2002;19(10):867–9.
Rudnisky C, Hinz B, Tennant M, et al. High-resolution stereoscopic digital fundus photography versus contact lens biomicroscopy for the detection of clinically significant macular edema. Ophthalmology. 2002;109(2):267–74.
Herbert HM, Jordan K, Flanagan DW. Is screening with digital imaging using one retinal view adequate? Eye. 2003;17(4):497–500.
Fluorescein angiographic risk factors for progression of diabetic retinopathy. ETDRS report number 13. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology. 1991;98(Suppl 5):834–40.
Shimizu K, Kobayashi Y, Muraoka K. Midperipheral fundus involvement in diabetic retinopathy. Ophthalmology. 1981;88(7):601–12.
Classification of diabetic retinopathy from fluorescein angiograms. ETDRS report number 11. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology. 1991;98(Suppl 5):807–22.
Bolz M, Schmidt-Erfurth U, Deak G, et al. Optical coherence tomographic hyperreflective foci: a morphologic sign of lipid extravasation in diabetic macular edema. Ophthalmology. 2009;116(5):914–20. Epub 2009/05/05.
Baskin DE. Optical coherence tomography in diabetic macular edema. Curr Opin Ophthalmol. 2010;21(3):172–7. Epub 2010/03/13.
Tangelder GJ, Van der Heijde RG, Polak BC, et al. Precision and reliability of retinal thickness measurements in foveal and extrafoveal areas of healthy and diabetic eyes. Invest Ophthalmol Vis Sci. 2008;49(6):2627–34. Epub 2008/06/03.
Browning DJ, Fraser CM. The predictive value of patient and eye characteristics on the course of subclinical diabetic macular edema. Am J Ophthalmol. 2008;145(1):149–54. Epub 2007/11/13.
Bolz M, Ritter M, Schneider M, et al. A systematic correlation of angiography and high-resolution optical coherence tomography in diabetic macular edema. Ophthalmology. 2009;116(1):66–72. Epub 2009/01/03.
Kohner E, Stratton I, Aldington S, et al. Relationship between the severity of retinopathy and progression to photocoagulation in patients with Type 2 diabetes mellitus in the UKPDS (UKPDS 52). Diabet Med. 2001;18(3):178–84.
The effect of intensive diabetes treatment on the progression of diabetic retinopathy in insulin-dependent diabetes mellitus. The Diabetes Control and Complications Trial. Arch Ophthalmol. 1995;113(1):36–51.
Squirrell D, Bhola R, Bush J, et al. A prospective, case controlled study of the natural history of diabetic retinopathy and maculopathy after uncomplicated phacoemulsification cataract surgery in patients with type 2 diabetes. Br J Ophthalmol. 2002;86(5):565–71.
Flesner P, Sander B, Henning V, et al. Cataract surgery on diabetic patients. A prospective evaluation of risk factors and complications. Acta Ophthalmol Scand. 2002;80(1):19–24.
Chung J, Kim MY, Kim HS, et al. Effect of cataract surgery on the progression of diabetic retinopathy. J Cataract Refract Surg. 2002;28(4):626–30.
Cunha-Vaz J. Lowering the risk of visual impairment and blindness. Diabet Med. 1998;15(Suppl 4):S47–50.
Aiello LP, Beck RW, Bressler NM, et al. Rationale for the diabetic retinopathy clinical research network treatment protocol for center-involved diabetic macular edema. Ophthalmology. 2011;118(12):e5–14. Epub 2011/12/06.
Elman MJ, Aiello LP, Beck RW, et al. Randomized trial evaluating ranibizumab plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic macular edema. Ophthalmology. 2010;117(6):1064–77. Epub 2010/04/30.
Nguyen QD, Shah SM, Khwaja AA, et al. Two-year outcomes of the ranibizumab for edema of the mAcula in diabetes (READ-2) study. Ophthalmology. 2010;117(11):2146–51. Epub 2010/09/22.
Massin P, Bandello F, Garweg JG, et al. Safety and efficacy of ranibizumab in diabetic macular edema (RESOLVE Study): a 12-month, randomized, controlled, double-masked, multicenter phase II study. Diabetes Care. 2010;33(11):2399–405. Epub 2010/10/29.
Elman MJ, Bressler NM, Qin H, et al. Expanded 2-year follow-up of ranibizumab plus prompt or deferred laser or triamcinolone plus prompt laser for diabetic macular edema. Ophthalmology. 2011;118(4):609–14. Epub 2011/04/05.
Nguyen QD, Brown DM, Marcus DM, et al. Ranibizumab for diabetic macular edema: results from 2 phase III randomized trials: RISE and RIDE. Ophthalmology. 2012;119(4):789–801. Epub 2012/02/15.
Mitchell P, Bandello F, Schmidt-Erfurth U, et al. The RESTORE study: ranibizumab monotherapy or combined with laser versus laser monotherapy for diabetic macular edema. Ophthalmology. 2011;118(4):615–25. Epub 2011/04/05.
Photocoagulation for diabetic macular edema. Early Treatment Diabetic Retinopathy Study report number 1. Early Treatment Diabetic Retinopathy Study research group. Arch Ophthalmol. 1985;103(12):1796–806.
Bailey C, Sparrow J, Grey R, et al. The National Diabetic Retinopathy Laser Treatment Audit. III. Clinical outcomes. Eye. 1999;13(Pt 2):151–9.
Focal photocoagulation treatment of diabetic macular edema. Relationship of treatment effect to fluorescein angiographic and other retinal characteristics at baseline: ETDRS report no. 19. Early Treatment Diabetic Retinopathy Study Research Group. Arch Ophthalmol. 1995;113(9):1144–55.
Gupta A, Gupta V, Dogra M, et al. Risk factors influencing the treatment outcome in diabetic macular oedema. Indian J Ophthalmol. 1996;44(3):145–8.
Preliminary report on effects of photocoagulation therapy. The Diabetic Retinopathy Study Research Group. Am J Ophthalmol. 1976;81(4):383–96.
Techniques for scatter and local photocoagulation treatment of diabetic retinopathy: Early Treatment Diabetic Retinopathy Study Report no. 3. The Early Treatment Diabetic Retinopathy Study Research Group. Int Ophthalmol Clin. 1987;27(4):254–64.
Googe J, Brucker AJ, Bressler NM, et al. Randomized trial evaluating short-term effects of intravitreal ranibizumab or triamcinolone acetonide on macular edema after focal/grid laser for diabetic macular edema in eyes also receiving panretinal photocoagulation. Retina. 2011;31(6):1009–27. Epub 2011/03/12.
Ferris F. Early photocoagulation in patients with either type I or type II diabetes. Trans Am Ophthalmol Soc. 1996;94:505–37.
Bodanowitz S, Hesse L, Weinand F, et al. Vitrectomy in diabetic patients with a blind fellow eye. Acta Ophthalmol Scand. 1996;74(1):84–8.
Filho JA, Messias A, Almeida FP, et al. Panretinal photocoagulation (PRP) versus PRP plus intravitreal ranibizumab for high-risk proliferative diabetic retinopathy. Acta Ophthalmol. 2011;89(7):567–72. Epub 2011/07/06.
Early photocoagulation for diabetic retinopathy. ETDRS report number 9. Early Treatment Diabetic Retinopathy Study Research Group. Ophthalmology. 1991;98(Suppl 5):766–85.
Early vitrectomy for severe vitreous hemorrhage in diabetic retinopathy. Four-year results of a randomized trial: Diabetic Retinopathy Study Report 5. The Diabetic Retinopathy Vitrectomy Study Research Group. Arch Ophthalmol. 1990;108(7):958–64.
Early vitrectomy for severe proliferative diabetic retinopathy in eyes with useful vision. Clinical application of results of a randomized trial--Diabetic Retinopathy Vitrectomy Study Report 4. The Diabetic Retinopathy Vitrectomy Study Research Group. Ophthalmology. 1988;95(10):1321–34.
Flaxel CJ, Edwards AR, Aiello LP, et al. Factors associated with visual acuity outcomes after vitrectomy for diabetic macular edema: diabetic retinopathy clinical research network. Retina. 2010;30(9):1488–95. Epub 2010/10/07.
Klein BE, Klein R, Moss SE. Incidence of cataract surgery in the Wisconsin Epidemiologic Study of Diabetic Retinopathy. Am J Ophthalmol. 1995;119(3):295–300.
Gupta A, Gupta V. Diabetic maculopathy and cataract surgery. Ophthalmol Clin North Am. 2001;14(4):625–37.
Udaondo P, Garcia-Pous M, Garcia-Delpech S, et al. Prophylaxis of macular edema with intravitreal ranibizumab in patients with diabetic retinopathy after cataract surgery: a pilot study. Journal of ophthalmology. 2011;2011:159436. Epub 2011/07/21.
Fard MA, Yazdanei Abyane A, Malihi M. Prophylactic intravitreal bevacizumab for diabetic macular edema (thickening) after cataract surgery: prospective randomized study. Eur J Ophthalmol. 2011;21(3):276–81. Epub 2010/09/21.
Takamura Y, Kubo E, Akagi Y. Analysis of the effect of intravitreal bevacizumab injection on diabetic macular edema after cataract surgery. Ophthalmology. 2009;116(6):1151–7. Epub 2009/04/21.
Rand LI, Prud’homme GJ, Ederer F, et al. Factors influencing the development of visual loss in advanced diabetic retinopathy. Diabetic Retinopathy Study (DRS) Report No. 10. Invest Ophthalmol Vis Sci. 1985;26(7):983–91.
Kohner EM, Barry PJ. Prevention of blindness in diabetic retinopathy. Diabetologia. 1984;26(3):173–9.
Dogru M, Nakamura M, Inoue M, et al. Long-term visual outcome in proliferative diabetic retinopathy patients after panretinal photocoagulation. Jpn J Ophthalmol. 1999;43(3):217–24.
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Stur, M., Egger, S., Haas, A. et al. Diagnose, Therapie und Verlaufskontrolle der diabetischen Augenerkrankung. Wien Klin Wochenschr 124 (Suppl 2), 50–57 (2012). https://doi.org/10.1007/s00508-012-0272-4
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DOI: https://doi.org/10.1007/s00508-012-0272-4
Schlüsselwörter
- Diabetische Retinopathie
- Diabetisches Makulaödem
- Retinale Laserkoagulation
- Intravitreale operative Medikamentenapplikation
- Vitrektomie