Retinopathy nonproliferative

The PKC-DRS Smdy Group. The effect of ruboxistaurin on visual loss in patients with moderately severe to very severe nonproliferative diabetic retinopathy initial results of the Protein Kinase C P Inhibitor Diabetic Retinopathy Smdy (PKC-DRS) multicenter randomized clinical trial. Diabetes 2005 54 2188. 

Diabetic macular edema (DME) is either focal or diffuse. As the severity of overall retinopathy increases, so does the proportion of eyes with macular edema. In a review, 3% of eyes with mild nonproliferative retinopathy had DME, 38% of eyes with moderate to severe non-prolif-erative retinopathy had DME, and 71% of eyes with proliferative changes had DME. In patients with diabetic retinopathy, CME usually occurs after long-standing DME. 

Amin RH, Frank RN, Kennedy A, Eliott D, Puklin JE, Abrams GW. Vascular endothelial growth factor is present in glial cells of the retina and optic nerve of human subjects with nonproliferative diabetic retinopathy. Invest Ophthalmal Vis Sci 1997 38 36-47. 

Recently, intravitreal triamcinolone acetonide has been used clinically to treat retinal vascular disease (Fig. 4). A case report by Jonas and Sofker (32) described a patient with nonproliferative diabetic retinopathy and a six-month history of persistent, diffuse macular edema despite grid photocoagulation. Following one intravitreal injection of triamcinolone acetonide, the visual acuity of this patient improved from 20/200 to 20/50 over a five-month follow-up period. It was also noted that there was marked regression of macular edema on clinical examination. Martidis et al. (33,34) reported on the use of intravitreal triamcinolone for refractory diabetic macular edema. Sixteen eyes with a macular thickness of at least 300 pm despite prior photocoagulation were treated with 4 mg injections of triamcinolone. At three-month follow-up the mean decrease in central retinal thickness was 57.5%, with a visual acuity increase of 2.4 Snellen lines. Those with six-month follow-up demonstrated some recurrence of edema and visual acuity improvement was reduced to 1.3 lines. 

Grant MB, Mames RN, Fitzgerald C et al. The efficacy of octreotide in the therapy of severe nonproliferative diabetic and early prohferative diabetic retinopathy. Diabetes Care 2000 23 504-509. 

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