Diabetic retinopathy is the most common eye complication of diabetes and one of the major causes of human blindness. The main causes of visual impairment are diabetic macular edema and proliferative diabetic retinopathy. From the perspective of endocrinologists, for patients with diabetic retinopathy, systemic treatments, including the control of blood glucose and blood lipids, are equally important as local treatment for the treatment of lesions that have occurred and prevention of visual impairment from occurring. Patients who need early intervention in diabetic retinopathy patients should be retained in the endocrinology department, and high-risk patients should be referred to the ophthalmology department, particularly those who need to be diagnosed and screened for severe non-proliferative retinopathy. This is a key issue to be solved. Through integration of the latest advances in epidemiological studies and clinical experiences, regular diabetic retinopathy screening, and intervention against risk factors, it is possible to prevent the occurrence of diabetic retinopathy. This chapter can help us understand how endocrinology and ophthalmology should work together to achieve the goal that the patients who need early intervention (not yet with diabetic retinopathy) stay in the endocrinology department for control of blood sugar, while high-risk patients (with diabetic retinopathy that may impact visual acuity) are referred to the ophthalmology department. Let’s work together to improve the quality of life of patients by preventing or reducing the occurrence of visual impairment.
This is a preview of subscription content, log in to check access.
Klein R, Klein BE, Moss SE, et al. The Wisconsin Epidemiologic Study of Diabetic Retinopathy: XVII. The 14-year incidence and progression of diabetic retinopathy and associated risk factors in type 1 diabetes. Ophthalmology. 1998;105(10):1801–15.CrossRefGoogle Scholar
Klein R, Klein BE, Moss SE, et al. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. II. Prevalence and risk of diabetic retinopathy when age at diagnosis is less than 30 years. Arch Ophthalmol. 1984;102(4):520–6.CrossRefPubMedGoogle Scholar
Klein R, Klein BE, Moss SE, et al. The Wisconsin Epidemiologic Study of Diabetic Retinopathy. III. Prevalence and risk of diabetic retinopathy when age at diagnosis is 30 or more years. Arch Ophthalmol. 1984;102(4):527–32.CrossRefPubMedGoogle Scholar
Wang NL, Wang FH, Liang YB. A survey on the current main eye diseases leading to blindness among the adults of Yongnian County, Hebei Province: a progression report of Handan Eye Diseases Study. J Capital Med Univ. 2010;31(1):11–7.Google Scholar
Keech AC, Mitchell P, Summanen PA, et al. Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study): a randomised controlled trial. Lancet. 2007;370:1687–97.CrossRefPubMedGoogle Scholar
ACCORD Study Group, ACCORD Eye Study Group. Effects of medical therapies on retinopathy progression in type 2 diabetes. N Engl J Med. 2010;363:233–44.CrossRefGoogle Scholar
Yang JK, Liu W, Shi J, et al. An association between subclinical hypothyroidism and sight-threatening diabetic retinopathy in type 2 diabetic patients. Diabetes Care. 2010;33(5):1018–20.CrossRefPubMedPubMedCentralGoogle Scholar