Prevention of Diabetic Retinopathy
The prevalence of diabetic retinopathy (DR) increases with the duration of the diabetes. Instability of glycemic control of diabetes is an important factor in DR’s appearance, progression, and severity, and the stability of strict glycemic control is the optimal way to favorably impact prevention.
Comorbid contributions to the progression of both the diabetes and complications such as DR result from hypertension, smoking, lipid abnormalities, kidney disease, and pregnancy. Treating these effectively improves the composite status to which they all contribute.
Prevention overlaps with treatment:
- Strict glycemic control in the early course of diabetes is necessary to prevent or mitigate DR
- With retinal pathology, photocoagulation (laser) for vision-threatening DR is indicated
- Intravitreal drugs
Prevention relies upon the recognition of the risk factors for DR. Frequent lapses in strict glycemic control that cause hyperglycemia, as well as hypertension, raise the risks for developing it. Effective prevention relies upon the following:
- Good diabetic management via strict glycemic control, according to the goals established by the doctor.
- Antihypertensive therapy for those with hypertension.
- Lipid-lowering therapy, using statins.
The benefit of lipid-lowering of improving overall cardiovascular status indirectly benefits patients with DR in that it increases their survival when there are conditions that contribute cardiac risk.