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British Journal of Ophthalmology 2004;88:433-435
© 2004 BMJ Publishing Group Ltd


Debate

CONTROVERSY

View 1: Should this patient receive laser treatment?

J Dowler

Series editors: Susan Lightman and Peter McCluskey

Moorfields Eye Hospital, City Road, London EC1V 2RD, UK; jonathan.dowler@moorfields.nhs.uk

Keywords: diabetic retinopathy; macular oedema; vision loss; vitrectomy

The first 150 words of the full text of this article appear below.

In patients with diabetic retinopathy, laser treatment is directed at the prevention of visual loss rather than at visual improvement. Treatment should therefore be applied before visual loss occurs, when the risk of visual loss justifies adverse effects of treatment. The risk of visual loss is linked to the likelihood of progression of retinopathy to sight threatening forms, which in turn depends on epidemiological factors such as sex, ethnicity, diabetes type, and duration; systemic factors such as hypertension, glycaemic control, and serum lipids; specific risk factors such as pregnancy, cataract surgery, and tightened glycaemic control; and, lastly, ophthalmoscopic signs (box 1Go).


Box Box 1 Factors influencing progression of diabetic retinopathy

Epidemiological factors (immutable)

Diabetes type, diabetes duration, ethnicity, sex

Systemic factors (modifiable)

Glycaemic control, hypertension, serum lipids, renal dysfunction

Specific risk factors (timeable)

Pregnancy, cataract surgery, tightened glycaemic control

Ophthalmoscopic signs

 

This patient has type 2 diabetes, and data from the . . . [Full text of this article]







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