Comments and Conclusions
- The Diabetes Control and Complications Trial (DCCT) as well as the United Kingdom Prospective Diabetes Study (UKPDS) have shown that hypertension is a significant risk factor in the development and progression of DR and should be aggressively controlled.1
- A target blood pressure of 130/75 mm Hg is suggested for any patient showing signs of retinopathy.2
- The DCCT observed that through intensive glycemic control, the risk for developing severe NPDR, PDR. CSME, and the need for laser surgery were reduced by 52% to 75% in patients with type 1 diabetes. The UKPDS found similar results in patients with type 2 diabetes.1
- Studies have shown that cholesterol may contribute to the development of diabetic retinopathy. A relationship between the total and low-density lipoproteins and the frequency of retinal hard exudates has been seen.1,2
- A linkage between diabetic retinopathy and renal disease has long been recognized. One such study on type 2 diabetes in white males showed that 76% of the patients who progressed to diabetic nephropathy had diabetic retinopathy.3
- Aggressive treatment for hypertension, hyperglycemia, and high cholesterol in early nephropathy delays need for dialysis and kidney transplant and hence death.6
- Early detection of diabetic retinopathy (such as with SD OCT and Panoramic Ophthalmoscopy) is equivalent to early detection of diabetic nephropathy and may result in better outcomes with timely intervention.