Diabetic Retinopathy: Pathogenesis, Treatment, and Complications

  • Samhitha Gudla
  • Divya Tenneti
  • Makrand Pande
  • Srinivas M. TipparajuEmail author


Diabetic retinopathy is a complication of diabetes. Majority of diabetic patients with high blood glucose face the challenge of dealing with retinopathy and macular edema as the disease progresses. Although treatment choices and care are available to manage and symptomatically treat Diabetic retinopathy the current understanding is limited and lacks options for treatment and rescue strategies. Pharmacological options include anti-VEGF treatment strategies and surgical procedures. The present review provides insights in to type of diabetic retinopathy, along with different stages of the disease. In addition, the roles for health care providers, importance of pharmacists for treatment and management of diabetic retinopathy patient care are discussed.


Diabetic retinopathy Drug delivery VEGF Glucose 


  1. 1.
    Colquitt J, Jones J, Tan S, Takeda A, Clegg A, Price A. Ranibizumab and pegaptanib for the treatment of age-related macular degeneration: a systematic review and economic evaluation. Health Technol Assess. 2008;12(16):iii.CrossRefGoogle Scholar
  2. 2.
    Spooner K, Hong T, Wijeyakumar W, Chang AA. Switching to aflibercept among patients with treatment-resistant neovascular age-related macular degeneration: a systematic review with meta-analysis. Clin Ophthalmol. 2017;Volume 11:161–77.CrossRefGoogle Scholar
  3. 3.
    Engerman RL. Pathogenesis of diabetic retinopathy. Diabetes. 1989;38(10):1203–6.CrossRefGoogle Scholar
  4. 4.
    Bresnick GH, Venecia GD, Myers FL, Harris JA, Davis MD. Retinal ischemia in diabetic retinopathy. Arch Ophthalmol. 1975;93(12):1300–10.CrossRefGoogle Scholar
  5. 5.
    Marshall G, Garg SK, Jackson WE, Holmes DL, Chase HP. Factors influencing the onset and progression of diabetic retinopathy in subjects with insulin-dependent diabetes mellitus. Ophthalmology. 1993;100(8):1133–9.CrossRefGoogle Scholar
  6. 6.
    Bandello F, Lattanzio R, Zucchiatti I, Petruzzi G. Non-proliferative diabetic retinopathy. In: Clinical strategies in the management of diabetic retinopathy. Springer-Verlag: Berlin Heidelberg; 2014. p. 19–63.Google Scholar
  7. 7.
    Shah KB, Han DP. Proliferative diabetic retinopathy. Int Ophthalmol Clin. 2004;44(4):69–84.CrossRefGoogle Scholar
  8. 8.
    Ivanisevic M. Stage M1: Maculopathy. A practical manual of diabetic retinopathy management; 2009. p. 70–98.Google Scholar
  9. 9.
    Dowler JGF. Laser management of diabetic retinopathy. J R Soc Med. 2003;96(6):277–9.CrossRefGoogle Scholar
  10. 10.
    Schwartz SG, Flynn HW. Pars plana vitrectomy for primary rhegmatogenous retinal detachment. Clin Ophthalmol. 2008;2:57.CrossRefGoogle Scholar
  11. 11.
    Cleary PE. The treatment of advanced diabetic eye disease. Ir J Med Sci. 1979;148(S2):38–44.CrossRefGoogle Scholar
  12. 12.
    Vijan S, Hofer TP, Hayward RA. Cost-utility analysis of screening intervals for diabetic retinopathy in patients with type 2 diabetes mellitus. JAMA. 2000;283(7):889.CrossRefGoogle Scholar
  13. 13.
    Macha S, Hughes P, Mitra A. Overview of ocular drug delivery. In: Ophthalmic drug delivery systems, vol. 25. 2nd ed. New York: Dekker; 2003. p. 1–12.Google Scholar
  14. 14.
    Grisanti S, Ziemssen F. Bevacizumab: off-label use in ophthalmology. Indian J Ophthalmol. 2007;55(6):417.CrossRefGoogle Scholar
  15. 15.
    Waisbourd M, Goldstein M, Loewenstein A. Treatment of diabetic retinopathy with anti-VEGF drugs. Acta Ophthalmol. 2010;89(3):203–7.CrossRefGoogle Scholar
  16. 16.
    Schmucker C, Ehlken C, Agostini HT, Antes G, Ruecker G, Lelgemann M, Loke YK. A safety review and meta-analyses of bevacizumab and Ranibizumab: off-label versus Goldstandard. PLoS One. 2012;7(8):e42701.CrossRefGoogle Scholar
  17. 17.
    Abraham A, Senthil S. Clinical ophthalmology: made easy. New Delhi: Jaypee Brothers Medical Publishers; 2013.CrossRefGoogle Scholar
  18. 18.
    Galvez MIL. Protein kinase C inhibitors in the treatment of diabetic retinopathy. Review. Curr Pharm Biotechnol. 2011;12(3):386–91.CrossRefGoogle Scholar
  19. 19.
    Augustin A. Anecortave acetate in the treatment of age-related macular degeneration. Clin Interv Aging. 2006;1(3):237–46.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Samhitha Gudla
    • 1
  • Divya Tenneti
    • 2
  • Makrand Pande
    • 3
  • Srinivas M. Tipparaju
    • 1
    • 4
    Email author
  1. 1.Department of Pharmaceutical SciencesUSF College of PharmacyTampaUSA
  2. 2.Sri Ramachandra Medical College and Research InstituteBangaloreIndia
  3. 3.University of South FloridaTampaUSA
  4. 4.College of Pharmacy, University of South FloridaTampaUSA

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