Proliferative Diabetic Retinopathy: Laser Treatment and Intravitreal Medication

Diabetic macular edema (DME) is the most common cause of visual impairment in patients with diabetes mellitus. It is characterized by the presence of increased retinal thickness with or without hard exudates. The pathogenesis is complex and multifactorial. DME may be focal or diffuse. Ischemia may also be present. Other than slit-lamp biomicroscopy and stereoscopic photography, fluorescein angiography (FA) and optical coherence tomography (OCT) are integrate part of the diagnosis and follow-up of patients with DME. Combination of information that is obtained by FA and OCT allows for appropriate management of DME. FA is useful for evaluating the severity of the dysfunction in the blood-retinal barrier and the detection of retinal ischemia; however, it does not reliably quantify the degree of fluid accumulation in the retina. OCT can detect early changes in retinal thickness despite normal findings on slit-lamp biomicroscopy. Diffuse retinal thickening, cystoid macular edema, serous retinal detachment and vitreomacular interface abnormalities can be seen by OCT in DME.