ytemic conideration in the management of diabetic retinopathy

PURPOE: To highlight the ytemic factor which affect onet and/or progreion of diabetic retinopathy (DR) and to emphaize the role and reponibilitie of ophthalmologit and other eye care provider to enure that appropriate ytemic medical evaluation of the patient with diabete i being purued. DEIGN: Literature review of publication relevant to diabetic retinopathy, blood glucoe control, diabete mellitu type, hypertenion, renal dieae, elevated erum lipid, exercie, pregnancy, anticoagulation, thrombolyi, moking, anemia and antioxidant ingetion. FINDING: Intenive blood glucoe control and control of ytemic hypertenion reduce the rik of new onet DR and low the progreion of exiting DR. evere DR may be an indicator of renal dieae while evere renal dieae and it treatment can affect the progreion of DR. Elevated erum lipid are aociated with macular exudate and moderate viual lo. Certain type of exceive exercie in patient with advanced tage of retinopathy may aggravate vitreou hemorrhage. During pregnancy, DR hould be monitored cloely a tranient progreion of DR can occur. Therapeutic anticoagulation and thrombolyi are not contraindicated at any tage of DR. Anemia can reult in progreion of DR, moking in general hould be dicouraged, and the role of antioxidant therapy require further tudy. CONCLUION: Blindne from diabetic retinopathy i now largely preventable with timely detection and appropriate interventional therapy. Routine, repetitive, lifelong, expert clinical retinal examination i eential for the fundamental ophthalmic care of the patient with diabete. However, diabete mellitu i a ytemic dieae and thu optimal ophthalmic care mut include diligent evaluation and treatment of concomitant ytemic diorder that influence the development, progreion and ultimate outcome of diabetic retinopathy. Optimization of thee ytemic conideration through an intenive, multi-diciplinary, healthcare team-baed approach will maximize the ophthalmic and general health of thee patient. Ophthalmologit and other eye care provider are critical member of thi team with unique reponibilitie to enure that appropriate ytemic medical evaluation i being purued.