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Diabetic retinopathy: Difference between revisions

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A genetic study showed that diabetic retinopathy shares a similar genetic predisposition with levels of [[glucose]], [[low-density lipoprotein cholesterol]], and [[systolic blood pressure]],<ref name=":4" /> indicating that glycemic control and cardiometabolic factors may be important in the development of diabetic retinopathy.
 
[[Lipid peroxidation]] plays a notable role in the progression of diabetic retinopathy. [[Free radical]]s such as hydroxyl and hydroperoxyl species with oxygen as functional group oxidize lipids and phospholipids, and at cellular level bring about membrane lipid peroxidation and in this way can trigger diabetic retinopathy.<ref>https://www.frontiersin.org/articles/{{cite journal | doi=10.3389/fphys.2013.00366/full | doi-access=free | title=Lipid peroxidation: Pathophysiological and pharmacological implications in the eye | date=2013 | last1=Njie-Mbye | first1=Ya Fatou | last2=Kulkarni-Chitnis | first2=Madhura | last3=Opere | first3=Catherine A. | last4=Barrett | first4=Aaron | last5=Ohia | first5=Sunny E. | journal=Frontiers in Physiology | volume=4 | page=366 | pmid=24379787 | pmc=3863722 }}</ref>
 
==Management==
There are four common treatments for diabetic retinopathy: [[anti-VEGF]] injections, [[steroid]] injections, panretinal laser photocoagulation, and [[vitrectomy]].<ref>{{Cite journal |lastlast1=Martinez-Zapata |firstfirst1=Maria José |last2=Salvador |first2=Ignacio |last3=Martí-Carvajal |first3=Arturo J. |last4=Pijoan |first4=José I. |last5=Cordero |first5=José A. |last6=Ponomarev |first6=Dmitry |last7=Kernohan |first7=Ashleigh |last8=Solà |first8=Ivan |last9=Virgili |first9=Gianni |date=2023-03-20 |title=Anti-vascular endothelial growth factor for proliferative diabetic retinopathy |url=https://pubmed.ncbi.nlm.nih.gov/36939655 |journal=The Cochrane Database of Systematic Reviews |volume=32023 |issue=3 |pages=CD008721 |doi=10.1002/14651858.CD008721.pub3 |issn=1469-493X |pmc=10026605 |pmid=36939655|pmc-embargo-date=March 20, 2024 }}</ref> Current treatment regimens can prevent 90% of severe vision loss.{{sfn|Flaxel|Adelman|Bailey|Fawzi|2020|loc="Early detection of diabetic retinopathy"}}
 
Although these treatments are very successful (in slowing or stopping further vision loss), they do not cure diabetic retinopathy. Caution should be exercised in treatment with laser surgery since it causes a loss of retinal tissue. It is often more prudent to inject triamcinolone or anti-VEGF drugs. In some patients it results in a marked increase of vision, especially if there is an [[macular edema|edema of the macula]].<ref name=":0">{{cite journal | vauthors = Mitchell P, Wong TY | title = Management paradigms for diabetic macular edema | journal = American Journal of Ophthalmology | volume = 157 | issue = 3 | pages = 505–13.e1–8 | date = March 2014 | pmid = 24269850 | doi = 10.1016/j.ajo.2013.11.012 }}</ref>
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