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Spotlight on diabetic retinopathy


Etiology and risk factors

The role of systemic risk factors in diabetic retinopathy

This review article examines the effects that systemic health factors and their management have on the risk of development of diabetic retinopathy.

Summary points
  • In the United States an estimated 5.5 million people over the age of 40 have diabetic retinopathy (DR) and over 20% of diabetes expenditure is spent on ophthalmic complications.
  • Patients with diabetes are more likely to have components of the metabolic syndrome (abdominal obesity, dyslipidemia, hypertension, prothrombotic state, and a proinflammatory state), which are associated with a higher risk of developing DR.
  • Patients’ risks of developing DR and retinopathy progression are affected by glycemic control, hypertension, cholesterol levels, and lifestyle management efforts (eg, obesity, sleep hygiene and activity levels).
  • Ophthalmologists are in a unique position to help motivate patients to control their diabetes, as the threat of vision loss can be a critical wake-up call for patients to invest in their health.

Atchison E, Barkmeier A. Curr Ophthalmol Rep 2016; 4: 84–89. doi: 10.1007/s40135-016-0098-8

Genetics of diabetic retinopathy

This review summarizes the findings of investigations aimed at uncovering the underlying genetic architecture of diabetic retinopathy susceptibility and discusses current efforts in the field.

Summary points
  • Diabetic retinopathy (DR) is a polygenic disorder and heritability has been estimated to be as high as 27% for DR and 52% for proliferative diabetic retinopathy (PDR), an advanced form of the disease.
  • The frequency and severity of DR among patients with diabetes mellitus is heterogeneous and known risk factors such as diabetes duration and glycemic control do not fully explain this observed heterogeneity.
  • There is a high concordance of DR severity among twins with both type 1 diabetes and type 2 diabetes, and siblings and relatives of diabetic patients with DR have approximately a 2- to 3-fold risk of DR when compared with relatives of diabetic patients without DR.
  • While there is strong evidence to suggest that DR is a heritable trait, linkage studies, candidate gene association studies and genome-wide association studies have not yet revealed any reproducible loci for DR.

Cho H, Sobrin L. Curr Diab Rep 2014; 14: 515. doi: 10.1007/s11892-014-0515-z

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