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Is Intensive Management of Blood Pressure to Prevent Visual Loss in Persons With Type 2 Diabetes Indicated?
Arch Ophthalmol. 2004;122:1707-1709.
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The Diabetic Retinopathy Study showed the efficacy of panretinal photocoagulation in preventing severe loss of vision in persons with proliferative diabetic retinopathy.1 The Early Treatment Diabetic Retinopathy Study (ETDRS) showed that focal and grid laser photocoagulation reduced the incidence of significant visual loss of 3 lines or more due to diabetic macular edema.2 While photocoagulation prevents loss of vision in many persons with diabetes, it is not without costs and complications, and may not always prevent the progression of disease or loss of vision.3 More recently, there has been interest in new surgical interventions, such as intravitreal injections of steroids and anti–vascular endothelial growth factors, to treat eyes with diabetic macular edema and proliferative diabetic retinopathy.4 These surgical interventions should be thought of as a tertiary prevention of more advanced complications associated with diabetic retinopathy.
A better strategy, in the absence of primary prevention of diabetes itself, is the prevention . . . [Full Text of this Article]
AUTHOR INFORMATION
Ronald Klein, MD, MPH
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