The way it was and the way it should be – the new approach to the treatment of nonproliferative diabetic retinopathy

Abstract

Diabetes has been declared an epidemic of the XXIst century by the World Health Organisation. Diabetic retinopathy, one of its main complications, is a leading cause of vision impairment among professionally active adults. Diabetic retinopathy is a microangiopathy that affects mainly small vessels, due to their highest vulnerability to hyperglycemia. Preventive measures involve mainly strict diabetic follow-ups, balanced level of glycated hemoglobin, blood pressure values and analysis of lipids. Regular ophthalmological check-ups and imaging tests of the retina are also extremely significant. For many years scientists have searched for a therapy to suppress vascular changes in diabetes. In May 2021 a stance on sulodexide use as a supporting treatment in mild and intermediate diabetic retinopathy was published by the Polish Society of Ophthalmology. Sulodexide protects vascular endothelium, contributes to endothelial cells’ function and has profibrinolytic, anti-inflammatory and vasoregulatory properties. These features make it a promising protective agent in the early stages of diabetic retinopathy.