당뇨망막병증의 예방적 관리와 치료 = Prevention and management of diabetic retinopathy

다국어 초록 (Multilingual Abstract)

Diabetic retinopathy(DR) is the leading cause of new onset blindness among working-aged groups in industrializedcountries, and its incidence is expected to increase along with the rising incidence of diabetes mellitus. Primary interventionssuch as strict glycemic control, tight blood pressure regulation, and lipid-lowering therapy can significantly reduce the riskof DR occurrence and progression. Currently, laser photocoagulation is the mainstay of treatment of proliferative DR andsome cases of diabetic macular edema (DME). However, a considerable number of DR patients still suffer from severevisual impairment in spite of the application of laser photocoagulation and even of pars plana vitrectomy. Consideringthe limitations of current DR treatments, ongoing efforts have been devoted to the development of new therapeuticstrategies, and it has become necessary to focus on pharmacologic treatment. Since inflammation has been identified asplaying a substantial role in the pathogenesis of DR, corticosteroids with an anti-inflammatory effect can be included in thetreatment of DR, though this may cause cataract and intraocular pressure elevation. The recent discovery of inhibitors ofvascular endothelial growth factor is a revolutionary event in the management of DR, specifically DME. Some new agentsaiming at the process of angiogenesis and increased vascular permeability are still under investigation, offering hope for amore effective future treatment of this sight-threatening disease. This paper reviews the current state of knowledge of theclinical presentation, preventive management, and clinical therapeutic strategies of DR and DME.

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