Treatment of neovascular age-related macular degeneration in patients with diabetes

Michael Cummings1, Jos&eacute; Cunha-Vaz21Academic Department of Diabetes and Endocrinology, Queen Alexandra Hospital, Portsmouth, UK; 2Department of Ophthalmology, University Hospital of Coimbra, Centre of Ophthalmology, Institute of Biomedical Research on Light and Image, Faculty of Medici...

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Autores principales:	Michael Cummings, Jos&eacute; Cunha-Vaz
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2008
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/d6cd97f2e14345019d857f5bf03ddb4a
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spelling	oai:doaj.org-article:d6cd97f2e14345019d857f5bf03ddb4a2021-12-02T05:54:12ZTreatment of neovascular age-related macular degeneration in patients with diabetes1177-54671177-5483https://doaj.org/article/d6cd97f2e14345019d857f5bf03ddb4a2008-06-01T00:00:00Zhttp://www.dovepress.com/treatment-of-neovascular-age-related-macular-degeneration-in-patients--a1792https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Michael Cummings1, Jos&eacute; Cunha-Vaz21Academic Department of Diabetes and Endocrinology, Queen Alexandra Hospital, Portsmouth, UK; 2Department of Ophthalmology, University Hospital of Coimbra, Centre of Ophthalmology, Institute of Biomedical Research on Light and Image, Faculty of Medicine, University of Coimbra, and Association for Innovation and Biomedical Research on Light and Image, Coimbra, PortugalAbstract: The number of patients with type 2 diabetes continues to rise; an anticipated 300 million people will be affected by 2025. The immense social and economic burden of the condition is exacerbated by the initial asymptomatic nature of type 2 diabetes, resulting in a high prevalence of micro- and macrovascular complications at presentation. Diabetic retinopathy, one of the potential microvascular complications associated with diabetes, and neovascular age-related macular degeneration (AMD) are the two most frequent retinal degenerative diseases, and are responsible for the majority of blindness due to retinal disease. Both conditions predominantly affect the central macula, and are associated with the presence of retinal edema and an aggressive inflammatory repair process that accelerates disease progression. The associated retinal edema and the inflammatory repair process are directly involved in the breakdown of the blood-retinal barrier (BRB). Yet, the underlying alterations to the BRB caused by the diseases are very different. The coexistence of the two conditions appears to be relatively uncommon, suggesting that diabetes may even protect patients from developing neovascular AMD. However, it is thought that the inflammatory repair responses associated with diabetic retinopathy and neovascular AMD may be cumulative and, in patients affected by both, could result in chronic diffuse cystoid edema. Treatment considerations in such patients should, therefore, include the role of retinal edema and the increased susceptibility of patients with diabetes to potential systemic side effects associated with agents administered repeatedly for neovascular AMD treatment.Keywords: diabetes, diabetic retinopathy, neovascular age-related macular degeneration, retina, edema Michael CummingsJos&eacute; Cunha-VazDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2008, Iss Issue 2, Pp 369-375 (2008)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Michael Cummings Jos&eacute; Cunha-Vaz Treatment of neovascular age-related macular degeneration in patients with diabetes
description	Michael Cummings1, Jos&eacute; Cunha-Vaz21Academic Department of Diabetes and Endocrinology, Queen Alexandra Hospital, Portsmouth, UK; 2Department of Ophthalmology, University Hospital of Coimbra, Centre of Ophthalmology, Institute of Biomedical Research on Light and Image, Faculty of Medicine, University of Coimbra, and Association for Innovation and Biomedical Research on Light and Image, Coimbra, PortugalAbstract: The number of patients with type 2 diabetes continues to rise; an anticipated 300 million people will be affected by 2025. The immense social and economic burden of the condition is exacerbated by the initial asymptomatic nature of type 2 diabetes, resulting in a high prevalence of micro- and macrovascular complications at presentation. Diabetic retinopathy, one of the potential microvascular complications associated with diabetes, and neovascular age-related macular degeneration (AMD) are the two most frequent retinal degenerative diseases, and are responsible for the majority of blindness due to retinal disease. Both conditions predominantly affect the central macula, and are associated with the presence of retinal edema and an aggressive inflammatory repair process that accelerates disease progression. The associated retinal edema and the inflammatory repair process are directly involved in the breakdown of the blood-retinal barrier (BRB). Yet, the underlying alterations to the BRB caused by the diseases are very different. The coexistence of the two conditions appears to be relatively uncommon, suggesting that diabetes may even protect patients from developing neovascular AMD. However, it is thought that the inflammatory repair responses associated with diabetic retinopathy and neovascular AMD may be cumulative and, in patients affected by both, could result in chronic diffuse cystoid edema. Treatment considerations in such patients should, therefore, include the role of retinal edema and the increased susceptibility of patients with diabetes to potential systemic side effects associated with agents administered repeatedly for neovascular AMD treatment.Keywords: diabetes, diabetic retinopathy, neovascular age-related macular degeneration, retina, edema
format	article
author	Michael Cummings Jos&eacute; Cunha-Vaz
author_facet	Michael Cummings Jos&eacute; Cunha-Vaz
author_sort	Michael Cummings
title	Treatment of neovascular age-related macular degeneration in patients with diabetes
title_short	Treatment of neovascular age-related macular degeneration in patients with diabetes
title_full	Treatment of neovascular age-related macular degeneration in patients with diabetes
title_fullStr	Treatment of neovascular age-related macular degeneration in patients with diabetes
title_full_unstemmed	Treatment of neovascular age-related macular degeneration in patients with diabetes
title_sort	treatment of neovascular age-related macular degeneration in patients with diabetes
publisher	Dove Medical Press
publishDate	2008
url	https://doaj.org/article/d6cd97f2e14345019d857f5bf03ddb4a
work_keys_str_mv	AT michaelcummings treatmentofneovascularagerelatedmaculardegenerationinpatientswithdiabetes AT josampeacutecunhavaz treatmentofneovascularagerelatedmaculardegenerationinpatientswithdiabetes
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Treatment of neovascular age-related macular degeneration in patients with diabetes

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