Prävention der diabetischen retinopathie

Despite the availability of effective treatment options such as photocoagulation, diabetic retinopathy still represents the leading cause of blindness in people of the work force in the industrialized states. One major problem lies in unsuccessful metabolic control and its accompanying arterial hypertension. Moreover, the fact that only about 50 % of diabetic patients are seen by an ophthalmologist on a regular basis certainly contributes to this process. By tight metabolic control, according to the guidelines recommended by the American Diabetes Association, and regular screening by an ophthalmologist, blindness can be prevented in almost all cases. This requires intensive cooperation and coordination between both diabetologists and ophthalmologists. Currently, an array of new medical advances, both oral and intravitreal, are being developed at experimental level and in clinical studies for the treatment of retinopathy and the prevention of visual loss. These include thrombocyte aggregation inhibitors, aldose reductase inhibitors, inhibition of the renin-angiotensin system, medical therapy using octreotide for hypophysectomy, growth factor inhibitors, calcium dobesilate, protein kinase C beta inhibitors, and triamcinolone. Retinal photocoagulation can reduce loss of vision by 50 % in clinically significant macular oedema. However, it is only indicated in severe non-proliferative cases.