Clinical Strategies in the Management of Diabetic Retinopathy

Summaries and insights into a complex disease

Leigh Spielberg

Posted: Tuesday, September 1, 2020

Clinical Strategies in the Management of Diabetic Retinopathy

As the diabetic epidemic spreads across the globe, diabetic retinopathy will follow, destroying the vision of millions. Despite the advent of anti-VEGF, the refinement of laser treatment and the increased insight into the disease’s pathogenesis, the complexity and chronicity inherent in its treatment will continue to hamper efforts to save sight.
It was with this in mind that I picked up the Second Edition of Clinical Strategies in the Management of Diabetic Retinopathy: A Step-by-Step Guide for Ophthalmologists (Springer). Edited by Francesco Bandello et al, the book addresses all aspects of the disease. It offers both summaries of well-established knowledge and insight into more recent studies.
Chapter 1 introduces the reader to diabetic retinopathy by way of epidemiology, risk factors and pathophysiology. This provides a framework in which to work.
Clinical Strategies is then divided by disease subtype, each of which requires a different approach.
Chapter 2 covers non-proliferative diabetic retinopathy, which the general ophthalmologist is likely to see on a daily basis. What I found most interesting in this chapter was the demonstration of the usefulness of newer imaging modalities, in the evaluation of this early stage, such as ultrawide-field angiography.
Next up is diabetic macular oedema (DME) in Chapter 3. DME, which arises from the breakdown of the blood-retinal barrier, leads to devastating central visual loss. The strength of this text is to efficiently compare the treatment modalities available for DME and offer recommendations as to which ones should be used, and when.
In Chapter 4, proliferative diabetic retinopathy (PDR) is addressed. It is comprehensively illustrated, showing examples of how to approach particular disease states, both diagnostically and therapeutically. Particularly useful are flow charts of therapeutic algorithms for the management of PDR. This advice continues in both Chapter 5, which presents a treatment update for PDR, and Chapter 6, on advanced PDR.
This 280-page book is appropriate for general ophthalmologists, medical & surgical retina fellows and established retina specialists who are looking to update and polish their knowledge in this exciting time for DRP treatment.