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Файл:Ординатура / Офтальмология / Учебные материалы / Clinical Strategies in the Management of Diabetic Retinopathy Springer.pdf
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- •Foreword
- •Preface
- •Contents
- •Contributors
- •Acronyms
- •1.1 Introduction
- •1.2 Epidemiology
- •1.3 Risk Factors
- •1.3.1 Duration of Diabetes Mellitus
- •1.3.2 Glycemic Control
- •1.3.3 Hypertension
- •1.3.4 Ethnic Differences
- •1.3.5 Obesity
- •1.3.6 Socioeconomic Status
- •1.3.7 Other Risk Factors
- •1.4 Pathophysiology
- •Conclusion
- •References
- •2: Non-proliferative Diabetic Retinopathy
- •2.1 Clinical Overview
- •2.1.1 Clinical Findings
- •2.1.2 Classification of NPDR
- •2.1.3 Atypical Forms of NPDR
- •2.2 Diagnostic Tools
- •2.2.1 Telemedicine
- •2.2.2 Fundus Photography
- •2.2.3 Fluorescein Angiography
- •2.2.4 Ultrasonography
- •2.2.5 Optical Coherence Tomography
- •2.2.6 Adaptive Optics Scanning Laser Ophthalmoscope
- •2.2.7 Multifocal Electroretinogram
- •2.2.8 Pattern Visual Evoked Potentials
- •2.2.9 Other Diagnostic Tools
- •2.3 Present Therapies
- •2.3.1 Primary Interventions
- •2.3.1.1 Glycemic Control
- •2.3.1.2 Blood Pressure Control
- •2.3.1.3 Lipid-Lowering Therapy
- •2.3.2 Secondary Interventions
- •2.3.2.1 Protein Kinase C Inhibitors
- •2.4 Evolving Algorithms
- •2.4.1 Screening
- •2.4.2 Laser Photocoagulation
- •2.5 New Frontiers
- •References
- •3: Diabetic Macular Edema
- •3.1 Clinical Overview
- •3.1.1 Clinical Findings
- •3.1.2 Biomicroscopic Classification of DME
- •3.2 Diagnostic Tools
- •3.2.1 Fluorescein Angiography
- •3.2.2 Optical Coherence Tomography
- •3.2.3 Fundus Photography
- •3.2.4 Microperimetry
- •3.2.5 Multifocal Electroretinogram
- •3.2.6 Other Imaging Under Investigation
- •3.3 Present Therapies
- •3.3.1 Laser Photocoagulation
- •3.3.2 Intravitreal Pharmacotherapies
- •3.3.2.1 Intravitreal Steroids
- •3.3.2.2 Intravitreal Anti-VEGF
- •3.3.3 Pars Plana Vitrectomy
- •3.4 Evolving Algorithms
- •3.4.1 Therapeutic Algorithms
- •3.4.2 Factors Associated with Favorable Response to the Therapy
- •3.4.3 Treatment of DME Associated with Macular Ischemia
- •3.5 New Frontiers
- •References
- •4: Proliferative Diabetic Retinopathy
- •4.1 Clinical Overview
- •4.1.1 Clinical Findings
- •4.1.2 Classification of PDR
- •4.2 Diagnostic Tools
- •4.2.1 Fluorescein Angiography
- •4.2.2 Fundus Photography
- •4.2.3 Ultrasonography
- •4.2.4 Optical Coherence Tomography
- •4.2.5 Perimetry
- •4.2.6 Further Diagnostic Tools
- •4.3 Present Therapies
- •4.3.1 Panretinal Laser Photocoagulation
- •4.3.2 Intravitreal Injections
- •4.3.2.1 Intravitreal Steroids
- •4.3.2.2 Intravitreal Anti-VEGF Agents
- •4.4 Evolving Algorithms
- •4.5 New Frontiers
- •References
- •5.1 Introduction
- •5.2 Pathophysiology
- •5.3 Neovascular Glaucoma
- •5.4 Tractional Retinal Detachment
- •5.5 Treatment
- •5.5.1 Panretinal Laser Photocoagulation
- •5.5.2 Pars Plana Vitrectomy and Endophotocoagulation
- •5.5.4 Silicone Oil Tamponade
- •5.5.4.1 Viscodissection
- •Conclusion
- •References
40 |
F. Bandello et al. |
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a |
b |
c |
d |
e
Fig. 2.23 Color (a) and red-free (b) images of severe exudative-edematous diabetic maculopathy, confirmed by OCT scan (e), in a case of pre-proliferative DR with cotton wool spots and ischemia inside the posterior pole (arrow). In the early angiographic phase (c), an enlargement of FAZ (foveal avascular zone) is evident; in the late phase (d), the areas with impaired perfusion remain hypofluorescent
2.2.8Pattern Visual Evoked Potentials
Pattern visual evoked potentials (P-VEP) have been tested in diabetic patients with NPDR and without any retinopathy revealing an increased latency as an earlier sign of retinal ganglion cell damage [52].
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