An Overview of Diabetic Retinopathy

Along with the worldwide increase in diabetes, an increase in patients with diabetic retinopathy (DR) is also expected. Among various ocular diabetic complications, DR has been recognized as the most significant damage that results in impaired vision and eventual vision loss. The basic pathogenesis of DR is microvascular injury due to hyperglycemia. However, during the disease progression, (1) retinal microangiopathy, (2) retinal neuropathy, and (3) retinal vitreopathy can be observed. Anti–vascular endothelial growth factor therapies have been developed, and various randomized large-scale clinical trials have shown their utility in DR, especially in diabetic macular edema (DME). Furthermore, because of limitations of current treatments, new pharmacological therapies are being developed, targeting the underlying biochemical mechanisms that cause DR/DME. Because systemic factors such as hypertension and hyperlipidemia are risk factors for the onset and development of DR, medical treatments and ophthalmic treatments are also important. In this chapter, we would like to introduce the epidemiology, current pathophysiological concepts, and recent advances in the management of DR.