By Francesco Bandello, Marco Attilio Zarbin, Rosangela Lattanzio, Ilaria Zucchiatti
With the arrival of potent remedies for diabetic retinopathy (DR), a brand new period within the administration of DR has been unfolded. Amid the deluge of licensed remedies and promising new innovations, despite the fact that, clinicians may perhaps locate it tough to settle on the precise perform in every one person case. the aim of this easy-to-use and richly illustrated guide is to help ophthalmologists in making judgements within the whole administration of DR in accordance with the easiest on hand proof. functional and entire innovations are supplied to lead clinicians in prognosis, decision-making, and remedy. The guide comprises useful algorithms and case histories when it comes to all phases of DR that in actual fact clarify the development of the sickness and should aid the clinician to decide on the easiest healing procedure. it is going to be a great source for ophthalmologists aiming to supply optimum scientific administration for this sight-threatening disease.
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Extra info for Clinical Strategies in the Management of Diabetic Retinopathy: A step-by-step Guide for Ophthalmologists
1 Telemedicine Screening programs resulted to be a cost-effective solution to reduce the risk of blindness in the working age . Telemedicine has been recently worldwide 32 F. Bandello et al. introduced for the screening of DR, especially to increase the access to health care, to give timely evaluation for DR, and to reduce the health costs . In addition these new technologies could also maximize the cooperation between ophthalmologists and other health-care specialists, such as diabetologists or pediatricians.
Flame-shaped hemorrhages are situated in the nerve fiber layer, while dot-blot hemorrhages are located in the inner nuclear layer and in both inner and outer plexiform layers of the retina. The appearance of the flame-shaped hemorrhages is related to the course of the nerve fiber layer, which runs parallel to the retinal surface, whereas the dot-blot hemorrhages are located in the other layers that course perpendicular to the retina (Figs. 5). Hard exudates are yellow, cereus intraretinal lipids, usually deposed at the posterior pole, secondary to the fluid accumulation .
The natural course of the DR at all stages could be monitored and compared at the next visits, especially in the early NPDR form, where no treatment is required, but only a closer follow-up and a proper systemic control is needed (Figs. 14). 2 Non-proliferative Diabetic Retinopathy 33 a b Fig. 13 Color photos of severe NPDR (or pre-proliferative DR) characterized by several widespread hemorrhages inside and outside the major vascular arcades, cotton wool spots (black arrows) at the posterior pole (a) and in the periphery (b) where vessels appear with increased caliber, and deviousness (white arrow) due to flow slowdown (venous beading) a b c Fig.
Clinical Strategies in the Management of Diabetic Retinopathy: A step-by-step Guide for Ophthalmologists by Francesco Bandello, Marco Attilio Zarbin, Rosangela Lattanzio, Ilaria Zucchiatti