Abstract
A retinopatia diabetica e a causa mais frequente de cegueira na populacao ativa nos paises desenvolvidos. A prevalencia da retinopatia diabetica aumenta com a duracao da diabetes, e praticamente 100% dos pacientes com diabetes tipo I (DM I) e mais do que 60% dos pacientes com o tipo II (DM II) apresentarao algum sinal de retinopatia apos 20 anos. Alem de um controle sistemico rigoroso dos niveis glicemicos, lipidicos, colesterol e da pressao arterial, o exame oftalmologico de rotina, com a identificacao precoce da retinopatia diabetica, podem detectar anormalidades em estagios primarios, o que possibilita o tratamento ainda na fase inicial do problema; o uso adequado da fotocoagulacao e a utilizacao da terapia antiangiogenica pode reduzir o numero de pacientes com hemorragia vitrea ou descolamento tracional da retina. Infelizmente, em varios pacientes, a retinopatia progride mesmo com as melhores condutas tomadas pelo paciente e pelo oftalmologista, embora varios olhos podem se beneficiar com o tratamento cirurgico, a vitrectomia posterior via pars plana. Esta revisao apresenta as indicacoes atuais para cirurgia vitreorretiniana em pacientes portadores de retinopatia diabetica proliferativa.
Highlights
Diabetic retinopathy (DR) is the most frequent cause of blindness among the economically active population in developed countries
The prevalence of DR increases with the duration of diabetes[1], and almost 100% of patients with type 1 diabetes (DM 1) and more than 60% of patients with type 2 (DM 2) will present some sign of DR after 20 years
A number of established guidelines are useful in the treatment of DR, such as laser photocoagulation and anti-vascular endothelial growth factor (VEGF) therapy, as well as strict systemic control of blood glucose levels, lipids, cholesterol and blood pressure[2,3]
Summary
Diabetic retinopathy (DR) is the most frequent cause of blindness among the economically active population in developed countries. Visual loss in RDP is caused by a combination of retinal ischemia, vitreous haemorrhage and/or tractional retinal detachment (TRD). Retinal detachment Tractional retinal detachment (TRD) involving the fovea causes significant visual loss and is a common indication for surgery in patients with DRP (Figure 2).
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