Preventing diabetic retinopathy through control of systemic factors.
OBJECTIVE
Diabetic retinopathy (DR), the leading cause of vision loss in working-age adults, is associated with many systemic factors that contribute to the severity and progression of this disease. Intensive glycemic and blood pressure control has been shown to delay both the onset and progression of diabetic retinopathy.


RESULTS
Studies involving angiotensin-converting enzyme inhibitors are currently underway to elucidate the efficacy of these drugs in further reducing the progression of diabetic retinopathy by means other than just hypertensive control. Dyslipidemia is associated with macular exudates and vision loss. Anticoagulation with aspirin is neither contraindicated in diabetics nor associated with prevention or progression of diabetic retinopathy. The effects of smoking on diabetic retinopathy are equivocal. Pregnancy may be associated with the progression of diabetic retinopathy in the absence of long-term effects if serum glucose levels are well monitored and controlled prior to and during pregnancy.


CONCLUSIONS
Genetic research is providing more insight into the pathogenesis and mechanisms of diabetic retinopathy, allowing possible identification of those at higher risk for developing diabetic retinopathy.
Jain
Atul
A
University of California, Los Angeles, School of Medicine, USA.
Sarraf
David
D
Fong
Donald
D
D000925:Anticoagulants / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D003925:Diabetic Angiopathies / Q000188:drug therapy; D003930:Diabetic Retinopathy / Q000235:genetics / Q000503:physiopathology / Q000517:prevention & control*; D018450:Disease Progression; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D006943:Hyperglycemia / Q000188:drug therapy; D006949:Hyperlipidemias / Q000628:therapy; D006973:Hypertension / Q000188:drug therapy; D007674:Kidney Diseases / Q000188:drug therapy; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000503:physiopathology / Q000628:therapy
D000925:Anticoagulants; D001241:Aspirin