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Journal of Ophthalmology
Volume 2017, Article ID 8234186, 10 pages
https://doi.org/10.1155/2017/8234186
Review Article

Update on Diagnosis and Treatment of Diabetic Retinopathy: A Consensus Guideline of the Working Group of Ocular Health (Spanish Society of Diabetes and Spanish Vitreous and Retina Society)

1Spanish Retina and Vitreous Society (SERV), IMO (Institut Microcirurgia Ocular), Barcelona, Spain
2Spanish Society of Diabetes (SED), Endocrinology Department, Valme University Hospital and RAMSE Foundation, Sevilla, Spain
3Spanish Society of Diabetes (SED), Endocrinology and Nutrition Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain
4Spanish Society of Diabetes (SED), Diabetes and Metabolism Research Unit and CIBERDEM (ISCIII), Vall d’Hebron Reseach Institute (VHIR), Barcelona, Spain
5Spanish Retina and Vitreous Society (SERV), Department of Ophthalmology, Castilla La Mancha University, Albacete, Spain
6University Hospital Puerta de Hierro-Majadahonda, Madrid, Spain
7Spanish Society of Diabetes (SED), Department of Endocrinology and Nutrition, University Clinic of Navarra, Pamplona, Spain
8Spanish Retina and Vitreous Society (SERV), Department of Ophthalmology, Nuevo Hospital Univeristario y Politécnico La Fe, Valencia, Spain

Correspondence should be addressed to Rafael Simó; gro.rihv@omis.leafar

Received 30 December 2016; Revised 20 April 2017; Accepted 23 May 2017; Published 14 June 2017

Academic Editor: Terri L. Young

Copyright © 2017 Borja Corcóstegui et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Linked References

  1. “Executive summary. IFD diabetes atlas, 7th edition,” November 2016, http://www.diabetesatlas.org/.
  2. P. Romero-Aroca, I. Mendez-Marin, M. Baget-Bernaldiz, J. Fernéndez-Ballart, and E. Santos-Blanco, “Review of the relationship between renal and retinal microangiopathy in diabetes mellitus patients,” Current Diabetes Reviews, vol. 6, pp. 88–101, 2010. View at Publisher · View at Google Scholar · View at Scopus
  3. C. K. Kramer, T. C. Rodrigues, L. H. Canani, J. L. Gross, and M. J. Azevedo, “Diabetic retinopathy predicts all-cause mortality and cardiovascular events in both type 1 and 2 diabetes: meta-analysis of observational studies,” Diabetes Care, vol. 34, pp. 1238–1244, 2011. View at Publisher · View at Google Scholar · View at Scopus
  4. The Diabetes Control and Complications Trial Research Group, “The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus,” The New England Journal of Medicine, vol. 329, pp. 977–986, 1993. View at Publisher · View at Google Scholar · View at Scopus
  5. UK Prospective Diabetes Study (UKPDS) Group, “Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33),” Lancet, vol. 352, pp. 837–853, 1998. View at Publisher · View at Google Scholar · View at Scopus
  6. B. E. Klein, “Overview of epidemiologic studies of diabetic retinopathy,” Ophthalmic Epidemiology, vol. 14, pp. 179–183, 2007. View at Google Scholar
  7. R. Williams, M. Airey, H. Baxter, J. Forrester, T. Kennedy-Martin, and A. Girach, “Epidemiology of diabetic retinopathy and macular oedema: a systematic review,” Eye (London, England), vol. 18, pp. 963–983, 2004. View at Publisher · View at Google Scholar · View at Scopus
  8. T. Y. Wong, C. M. Cheung, M. Larsen, S. Sharma, and R. Simó, “Diabetic retinopathy,” Nature Reviews Disease Primers, vol. 2, p. 16012, 2016. View at Publisher · View at Google Scholar · View at Scopus
  9. R. Simó, E. Carrasco, M. García-Ramírez, and C. Hernández, “Angiogenic and antiangiogenic factors in proliferative diabetic retinopathy,” Current Diabetes Reviews, vol. 2, pp. 71–98, 2006. View at Publisher · View at Google Scholar · View at Scopus
  10. R. Simó, J. M. Sundstrom, and D. A. Antonetti, “Ocular anti-VEGF therapy for diabetic retinopathy: the role of VEGF in the pathogenesis of diabetic retinopathy,” Diabetes Care, vol. 37, pp. 893–899, 2014. View at Publisher · View at Google Scholar · View at Scopus
  11. G. S. Tan, N. Cheung, R. Simó, G. C. Cheung, and T. Y. Wong, “Diabetic macular oedema,” The Lancet Diabetes and Endocrinology, vol. 5, pp. 143–155, 2017. View at Publisher · View at Google Scholar · View at Scopus
  12. R. Simó, C. Hernández, and European Consortium for the Early Treatment of Diabetic Retinopathy (EUROCONDOR), “Neurodegeneration in the diabetic eye: new insights and therapeutic perspectives,” Trends in Endocrinology and Metabolism, vol. 25, pp. 23–33, 2014. View at Publisher · View at Google Scholar · View at Scopus
  13. R. Simó and C. Hernández, “Novel approaches for treating diabetic retinopathy based on recent pathogenic evidence,” Progress in Retinal and eye Research, vol. 48, pp. 160–180, 2015. View at Publisher · View at Google Scholar · View at Scopus
  14. Early Treatment Diabetic Retinopathy Study Research Group, “Classification of diabetic retinopathy from fluorescein angiograms. ETDRS report number 11,” Ophthalmology, vol. 98, pp. 807–822, 1991. View at Publisher · View at Google Scholar
  15. Early Treatment Diabetic Retinopathy Study Research Group, “Grading diabetic retinopathy from stereoscopic color fundus photographs—an extension of the modified Airlie House classification. ETDRS report number 10,” Ophthalmology, vol. 98, pp. 786–806, 1991. View at Publisher · View at Google Scholar
  16. American Academy of Ophthalmology Retina/Vitreous Panel Preferred Practice Pattern Guidelines, Diabetic Retinopathy, American Academy of Ophthalmology, San Francisco, CA, 2016, November 2016, http://www.aao.org/ppp.
  17. The Diabetes Control and Complications Trial Research Group, “Early worsening of diabetic retinopathy in the diabetes control and complications trial,” Archives of Ophthalmology, vol. 116, pp. 874–886, 1998. View at Publisher · View at Google Scholar
  18. M. Henricsson, A. Nilsson, L. Janzon, and L. Groop, “The effect of glycaemic control and the introduction of insulin therapy on retinopathy in non-insulin-dependent diabetes mellitus,” Diabetic Medicine, vol. 14, pp. 123–131, 1997. View at Publisher · View at Google Scholar
  19. R. J. Casson, J. P. M. Wood, and N. N. Osborne, “Hypoglycemia exacerbates ischaemic retinal injury in rats,” The British Journal of Ophthalmology, vol. 88, pp. 816–820, 2004. View at Publisher · View at Google Scholar · View at Scopus
  20. J. W. Y. Yau, S. L. Rogers, R. Kawasaki et al., “Global prevalence and major risk factors for diabetic retinopathy,” Diabetes Care, vol. 35, pp. 556–564, 2012. View at Publisher · View at Google Scholar · View at Scopus
  21. L. S. Lim and T. Y. Wong, “Lipids and diabetic retinopathy,” Expert Opinion on Biological Therapy, vol. 12, pp. 93–105, 2012. View at Google Scholar
  22. K. C. Donaghue, J. M. Fairchild, M. E. Craig et al., “Do all prepubertal years of diabetes duration contribute equally to diabetes complications?” Diabetes Care, vol. 26, pp. 1224–1229, 2003. View at Publisher · View at Google Scholar · View at Scopus
  23. B. E. Klein, S. E. Moss, and R. Klein, “Effect of pregnancy on progression of diabetic retinopathy,” Diabetes Care, vol. 13, pp. 34–40, 1990. View at Publisher · View at Google Scholar
  24. P. Kotlarsky, A. Bolotin, K. Dorfman, B. Knyazer, T. Lifshitz, and J. Levy, “Link between retinopathy and nephropathy caused by complications of diabetes mellitus type 2,” International Ophthalmology, vol. 35, pp. 59–66, 2015. View at Publisher · View at Google Scholar · View at Scopus
  25. C. W. Wong, T. Y. Wong, C. Y. Cheng, and C. Sabanayagam, “Kidney and eye diseases: common risk factors, etiological mechanisms, and pathways,” Kidney International, vol. 85, pp. 1290–1302, 2014. View at Publisher · View at Google Scholar · View at Scopus
  26. N. Cheung and T. Y. Wong, “Obesity and eye diseases,” Survey of Ophthalmology, vol. 52, pp. 180–195, 2007. View at Publisher · View at Google Scholar · View at Scopus
  27. L. C. Rodríguez-García, A. Gómez de Cádiz Villarreal, J. Pérez Rivas, J. J. Muñoz González, G. García Álvarez, and M. T. Alonso Salazar, “Implantación del cribado de retinopatía diabética mediante retinografía digital en atención primaria,” Atencion Primaria, vol. 45, pp. 149–156, 2013. View at Publisher · View at Google Scholar · View at Scopus
  28. C. D. Jones, R. H. Greenwood, A. Misra, and M. O. Bachmann, “Incidence and progression of diabetic retinopathy during 17 years of a population-based screening program in England,” Diabetes Care, vol. 35, pp. 592–596, 2012. View at Publisher · View at Google Scholar · View at Scopus
  29. E. Olafsdóttir and E. Stefánsson, “Biennial eye screening in patients with diabetes without retinopathy: 10-year experience,” The British Journal of Ophthalmology, vol. 91, pp. 1599–1601, 2007. View at Publisher · View at Google Scholar · View at Scopus
  30. D. Chalk, M. Pitt, B. Vaidya, and K. Stein, “Can the retinal screening interval be safely increased to 2 years for type 2 diabetic patients without retinopathy?” Diabetes Care, vol. 35, pp. 1663–1668, 2012. View at Publisher · View at Google Scholar · View at Scopus
  31. S. H. Solomon, E. Chew, E. Duh et al., “Diabetic retinopathy: a position statement by the American Diabetes Association,” Diabetes Care, vol. 40, pp. 412–418, 2017. View at Publisher · View at Google Scholar
  32. T. E. de Carlo, A. T. Chin, M. A. Bonini Filho et al., “Detection of microvascular changes in eyes of patients with diabetes but not clinical diabetic retinopathy using optical coherence tomography angiography,” Retina, vol. 35, pp. 2364–2370, 2015. View at Publisher · View at Google Scholar
  33. H. E. Wiley and F. L. Ferris III, “Nonproliferative diabetic retinopathy and diabetic macular edema,” Retina, Elsevier Saunders, London, United Kingdom, 2013. View at Google Scholar
  34. K. A. Kwiterovich, M. G. Maguire, R. P. Murphy et al., “Frequency of adverse systemic reactions after fluorescein angiography,” Ophthalmology, vol. 98, pp. 1139–1142, 1998. View at Google Scholar
  35. T. E. de Carlo, M. A. Bonini Filho, A. T. Chin et al., “Spectral domain optical coherence tomography angiography (OCTA) of choroidal neovascularization,” Ophthalmology, vol. 122, pp. 1228–1238, 2015. View at Publisher · View at Google Scholar · View at Scopus
  36. T. E. de Carlo, A. Romano, N. K. Waheed, and J. S. Duker, “A review of optical coherence tomography angiography (OCTA),” International Journal of Retina and Vitreous, vol. 1, p. 5, 2015. View at Publisher · View at Google Scholar
  37. R. F. Spaide, J. M. Klancnik Jr., and M. J. Cooney, “Retinal vascular layers imaged by fluorescein angiography and optical coherence tomography angiography,” JAMA Ophthalmology, vol. 133, pp. 45–50, 2015. View at Publisher · View at Google Scholar · View at Scopus
  38. A. Ishibazawa, T. Nagaoka, A. Takahashi et al., “Optical coherence tomography angiography in diabetic retinopathy: a prospective pilot study,” American Journal of Ophthalmology, vol. 160, pp. 34–44, 2015. View at Publisher · View at Google Scholar · View at Scopus
  39. K. Sambhav, K. K. Abu-Amero, and K. V. Chalam, “Deep capillary macular perfusion indices obtained with OCT angiography correlate with degree of nonproliferative diabetic retinopathy,” European Journal of Ophthalmology, 2017. View at Publisher · View at Google Scholar
  40. J. M. de Barros Garcia, D. L. Isaac, and M. Avila, “Diabetic retinopathy and OCT angiography: clinical findings and future prespectives,” International Journal of Retina and Vitreous, vol. 3, p. 14, 2017. View at Publisher · View at Google Scholar
  41. I. M. Stratton, A. I. Adler, H. A. Neil et al., “Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study,” BMJ, vol. 321, pp. 405–412, 2000. View at Publisher · View at Google Scholar
  42. X. Zhang, J. Zhao, T. Zhao, and H. Liu, “Effects of intensive glycemic control in ocular complications in patients with type 2 diabetes: a meta-analysis of randomized clinical trials,” Endocrine, vol. 49, pp. 78–89, 2015. View at Publisher · View at Google Scholar · View at Scopus
  43. E. Y. Chew, “There is level 1 evidence for intensive glycemic control for reducing the progression of diabetic retinopathy in persons with type 2 diabetes,” Endocrine, vol. 49, pp. 1–3, 2015. View at Publisher · View at Google Scholar · View at Scopus
  44. UK Prospective Diabetes Study Group, “Tight blood pressure control and risk of macrovascular and microvascular complications in type 2 diabetes: UKPDS 38,” BMJ, vol. 317, pp. 703–713, 1998. View at Publisher · View at Google Scholar
  45. E. Y. Chew, W. T. Ambroisus, M. D. Davis et al., “Effects of medical therapies on retinopathy progression in type 2 diabetes,” The New England Journal of Medicine, vol. 363, pp. 233–244, 2010. View at Publisher · View at Google Scholar · View at Scopus
  46. F. M. Sacks, M. P. Hermans, P. Fioretto et al., “Association between plasma triglycerides and high-density lipoprotein cholesterol and microvascular kidney disease and retinopathy in type 2 diabetes mellitus: a global case-control study in 13 countries,” Circulation, vol. 129, pp. 999–1008, 2014. View at Publisher · View at Google Scholar · View at Scopus
  47. J. Morton, S. Zoungas, Q. Li et al., “Low HDL cholesterol and the risk of diabetic nephropathy and retinopathy: results of the ADVANCE study,” Diabetes Care, vol. 35, pp. 2201–2206, 2012. View at Publisher · View at Google Scholar · View at Scopus
  48. A. C. Keech, P. Mitchell, P. A. Summanen et al., “Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study): a randomised controlled trial,” Lancet, vol. 370, pp. 1687–1697, 2007. View at Publisher · View at Google Scholar · View at Scopus
  49. The ACCORD Study Group and ACCORD Eye Study Group, “Effects of medical therapies on retinopathy progression in type 2 diabetes,” The New England Journal of Medicine, vol. 363, pp. 233–244, 2010. View at Publisher · View at Google Scholar · View at Scopus
  50. R. Simó and C. Hernández, “Prevention and treatment of diabetic retinopathy: evidence from large, randomized trials. The emerging role of fenofibrate,” Reviews on Recent Clinical Trials, vol. 7, pp. 71–80, 2012. View at Publisher · View at Google Scholar · View at Scopus
  51. N. Sharma, J. L. Ooi, J. Ong, and D. Newman, “The use of fenofibrate in the management of patients with diabetic retinopathy: an evidence-based review,” Australian Family Physician, vol. 44, pp. 367–370, 2015. View at Google Scholar
  52. R. Simó, S. Roy, F. Behar-Cohen, A. Keech, P. Mitchell, and T. Y. Wong, “Fenofibrate: a new treatment for diabetic retinopathy. Molecular mechanisms and future perspectives,” Current Medicinal Chemistry, vol. 20, pp. 3258–3266, 2013. View at Publisher · View at Google Scholar · View at Scopus
  53. P. Venkatesh, S. Tibrewal, D. Bhowmik et al., “Prevalence of systemic co-morbidities in patients with various grades of diabetic retinopathy,” The Indian Journal of Medical Research, vol. 140, pp. 77–83, 2014. View at Google Scholar
  54. H. El Rami, R. Barham, J. K. Sun, and P. S. Silva, “Evidence-based treatment of diabetic retinopathy,” Seminars in Ophthalmology, vol. 32, pp. 67–74, 2017. View at Google Scholar
  55. U. Schmidt-Erfurth, J. Garcia-Arumi, F. Bandello et al., “Guidelines for the management of diabetic macular edema by the European Society of Retina Specialists (EURETINA),” Ophthalmologica, vol. 237, no. 4, pp. 185–222, 2017. View at Publisher · View at Google Scholar
  56. B. J. Thomas, G. Shienbaum, D. S. Boyer, and H. W. Flynn Jr., “Evolving strategies in the management of diabetic macular edema: clinical trials and current management,” Canadian Journal of Ophthalmology, vol. 48, pp. 22–30, 2013. View at Google Scholar
  57. M. Ashraf, A. Souka, R. Adelman, and S. H. Forster, “Aflibercept in diabetic macular edema: evaluating efficacy as a primary and secondary therapeutic option,” Eye (London, England), vol. 30, no. 12, pp. 1531–1541, 2016. View at Publisher · View at Google Scholar · View at Scopus
  58. D. M. Brown, Q. D. Nguyen, D. M. Marcus et al., “Long-term outcomes of ranibizumab therapy for diabetic macular edema: the 36-month results from two phase III trials: RISE and RIDE,” Ophthalmology, vol. 120, pp. 2013–2022, 2013. View at Publisher · View at Google Scholar · View at Scopus
  59. P. Mitchell, F. Bandello, U. Schmidt-Erfurth et al., “The RESTORE study: ranibizumab monotherapy or combined with laser versus laser monotherapy for diabetic macular edema,” Ophthalmology, vol. 118, pp. 615–625, 2011. View at Publisher · View at Google Scholar · View at Scopus
  60. U. Schmidt-Erfurth, G. E. Lang, F. G. Holz et al., “Three-year outcomes of individualized ranibizumab treatment in patients with diabetic macular edema: the RESTORE extension study,” Ophthalmology, vol. 121, pp. 1045–1053, 2014. View at Publisher · View at Google Scholar · View at Scopus
  61. J. F. Korobelnik, D. V. Do, U. Schmidt-Erfurth et al., “Intravitreal aflibercept for diabetic macular edema,” Ophthalmology, vol. 121, pp. 2247–2254, 2014. View at Publisher · View at Google Scholar · View at Scopus
  62. D. M. Brown, U. Schmidt-Erfurth, D. V. Do et al., “Intravitreal aflibercept for diabetic macular edema: 100-week results from the VISTA and VIVID studies,” Ophthalmology, vol. 122, pp. 2044–2052, 2015. View at Publisher · View at Google Scholar · View at Scopus
  63. G. Virgili, M. Parravano, F. Menchini, and J. R. Evans, “Anti-vascular endothelial growth factor for diabetic macular oedema,” Cochrane Database of Systematic Reviews, vol. 10, article CD007419, 2014. View at Publisher · View at Google Scholar · View at Scopus
  64. S. Régnier, W. Malcolm, F. Allen, J. Wright, and V. Bezlyak, “Efficacy of anti-VEGF and laser photocoagulation in the treatment of visual impairment due to diabetic macular edema: a systematic review and network meta-analysis,” PloS One, vol. 9, article e102309, 2014. View at Publisher · View at Google Scholar · View at Scopus
  65. J. M. Ruiz-Moreno, “Nuevas perspectivas en el abordaje del edema macular diabético. Tratamiento con aflibercept,” Archivos de la Sociedad Española de Oftalmología, vol. 90, Supplement 1, pp. 24–28, 2015. View at Google Scholar
  66. J. A. Wells, A. R. Glassman, A. R. Ayala et al., “Aflibercept, bevacizumab, or ranibizumab for diabetic macular edema,” The New England Journal of Medicine, vol. 372, pp. 1193–1203, 2015. View at Publisher · View at Google Scholar · View at Scopus
  67. J. A. Wells, A. R. Glassman, A. R. Ayala et al., “Aflibercept, bevacizumab, or ranibizumab for diabetic macular edema: two-year results from a comparative effectiveness randomized clinical trial,” Ophthalmology, vol. 123, pp. 1351–1359, 2016. View at Publisher · View at Google Scholar · View at Scopus
  68. L. P. Aiello, R. L. Avery, P. G. Arrigg et al., “Vascular endothelial growth factor in ocular fluid of patients with diabetic retinopathy and other retinal disorders,” The New England Journal of Medicine, vol. 331, pp. 1480–1487, 1994. View at Publisher · View at Google Scholar · View at Scopus
  69. The Royal College of Ophthalmology, “Diabetic retinopathy guidelines,” November 2016, https://www.rcophth.ac.uk/wp-content/uploads/2014/12/2013-SCI-301-FINAL-DR-GUIDELINES-DEC-2012-updated-July-2013.pdf.
  70. P. A. Campochiaro, D. M. Brown, A. Pearson et al., “Sustained delivery fluocinolone acetonide vitreous inserts provide benefit for at least 3 years in patients with diabetic macular edema,” Ophthalmology, vol. 119, pp. 2125–2132, 2012. View at Publisher · View at Google Scholar · View at Scopus
  71. D. S. Boyer, Y. H. Yoon, R. Belfort et al., “Three year, randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with diabetic macular edema,” Ophthalmology, vol. 121, pp. 1904–1914, 2014. View at Publisher · View at Google Scholar · View at Scopus
  72. M. W. Stewart, “Treatment of diabetic retinopathy: recent advances and unresolved challenges,” World Journal of Diabetes, vol. 7, pp. 333–341, 2016. View at Publisher · View at Google Scholar
  73. J. Cunha-Vaz, P. Ashton, R. Iezzi et al., “Sustained delivery fluocinolone acetonide vitreous implants: long term benefit in patients with chronic diabetic macular edema,” Ophthalmology, vol. 121, pp. 1892–1903, 2014. View at Publisher · View at Google Scholar · View at Scopus
  74. Writing Committee for the Diabetic Retinopathy Clinical Research Network, J. G. Gross, A. R. Lassman et al., “Panretinal photocoagulation vs intravitreous ranibizumab for proliferative diabetic retinopathy: a randomized clinical trial,” Jama, vol. 314, pp. 2137–2146, 2015. View at Publisher · View at Google Scholar · View at Scopus
  75. J. Lin, J. S. Chang, and W. E. Smiddy, “Cost evaluation of panretinal photocoagulation versus intravitreal ranibizumab for proliferative diabetic retinopathy,” Ophthalmology, vol. 123, pp. 1912–1918, 2016. View at Publisher · View at Google Scholar · View at Scopus
  76. T. Sharma, A. Fong, T. Y. Lai, V. Lee, S. Das, and D. Lam, “Surgical treatment for diabetic vitreoretinal diseases: a review,” Clinical and Experimental Ophthalmology, vol. 44, pp. 340–354, 2016. View at Publisher · View at Google Scholar · View at Scopus
  77. M. H. Berrocal, L. A. Acaba, and A. Acaba, “Surgery for diabetic eye complications,” Current Diabetes Reports, vol. 16, p. 99, 2016. View at Google Scholar