Medical treatment of retinopathy of type-2 diabetes

The medical treatment of retinopathy in type-2 diabetes should be considered as a major component in the overall management of diabetic retinal disease. It is clear that specific and timely interventions, such as glycemic and blood pressure control, are the basis for good management of diabetic retinopathy. The American Diabetes Association has developed specific recommendations concerning diabetic retinopathy for the primary care physician and diabetologist. The ophthalmologist must be aware of these recommendations and establish efficient communication channels with the colleagues who follow their patients and the progression of diabetes closely. The challenge for the ophthalmologist is to make sure that, when signs of retinopathy are detected, information regarding the status of the retina, prognostic factors and the rate of progression must be given to the primary care physician and diabetologist. Under these circumstances, excellent glycemic control, aggressive management of blood pressure and normalization of lipids are all needed, and the goals to be achieved must be shared between the ophthalmologist and the primary care physician or diabetologist. Appropriate medical management of diabetic retinopathy is fundamental to reduce the risk of blindness. This goal can only be achieved if the ophthalmologist is fully aware of the role of medical management and establishes an efficient flow of communication with the primary care physician or diabetologist, particularly for the diabetic patients whose eyes show signs of risk for rapid progression of their retinopathy.