[Guidelines of clinical practice of the SERV (Spanish Retina and Vitreous Society): management of ocular complications of diabetes. Diabetic retinopathy and macular oedema].
OBJECTIVE
Diabetes mellitus is considered the most common cause of blindness in the working population of industrialized countries, with diabetic macular edema being the most common cause of decreased visual acuity and proliferative diabetic retinopathy (PDR) being responsible for the most severe visual deficits. We have therefore tried to establish a guide for clinical intervention whose purpose is to provide orientation on the treatment of diabetic retinopathy and its complications. This is necessary at a time when many treatment options have emerged whose role is not yet fully defined.


METHODS
A group of expert retina specialists selected by the SERV (Vitreous-Retina Spanish Society) assessed the published results of different treatment options currently available, suggesting lines of action according to the degree of diabetic retinopathy present and the presence or absence of macular edema.


RESULTS
PDR is primarily treated with pan-retinal photocoagulation. For clinically significant diabetic macular edema without signs of vitreomacular traction, the treatment of choice continues to be focal/grid photocoagulation. Similarly, retinovitreal surgery is indicated for both conditions. The use of antiangiogenic drugs was also analyzed but remains inconclusive.


CONCLUSIONS
Laser therapy is effective in the management of diabetic retinopathy and diabetic macular edema. The role of antiangiogenics is not yet sufficiently defined.
Pareja-Ríos
A
A
Hospital Universitario de Canarias, La Laguna, Tenerife, España. aparejar@gmail.com
Serrano-García
M A
MA
Marrero-Saavedra
M D
MD
Abraldes-López
V M
VM
Reyes-Rodríguez
M A
MA
Cabrera-López
F
F
López-Gálvez
M
M
Cardona-Guerra
P
P
Abreu-Reyes
P
P
Quijada-Fumero
E
E
Coronado-Toural
A
A
Gutiérrez-Sánchez
E
E
Gil-Hernández
M A
MA
Valls-Quintana
P
P
Marín-Olmos
F
F
Navarro-Alemany
R
R
D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000008:administration & dosage / Q000627:therapeutic use; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D002386:Cataract / Q000209:etiology; D002387:Cataract Extraction; D048909:Diabetes Complications / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery*; D003930:Diabetic Retinopathy / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery*; D005451:Fluorescein Angiography; D006801:Humans; D056965:Injections, Intraocular; D008028:Light Coagulation / Q000379:methods; D008269:Macular Edema / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000601:surgery*; D012166:Retinal Hemorrhage / Q000000981:diagnostic imaging; D012720:Severity of Illness Index; D041623:Tomography, Optical Coherence; D014463:Ultrasonography; D014821:Vitrectomy; D014822:Vitreous Body
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab