![]() ![]() 9Īdvanced DR or PDR represents angiogenic response of the retina to extensive ischaemia from capillary closure. 8 The incidence of sight-threatening DR is more in type 1 when compared with type 2 DM. 7 Sight-threatening DR or vision-threatening DR is defined as “presence of severe non-proliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR) and/or macular oedema in at least one eye”. 6 Additionally, no significant inter-gender difference was observed in the DR prevalence (females: 25.93% males: 28.95%). 6 However, a disproportionate representation of DR is observed across geography where maximum prevalence is observed in Middle East and North Africa and the Western Pacific. 5–7 In 2020, the individuals affected with DR is estimated to be 103.12 million which is projected to increase to 160.50 million by 2045. 4 The global prevalence of DR was observed to be ranging between 22% and 35% in patients with diabetes as reported in different studies. 3 It was established that diabetic retinopathy (DR) is one of the major diabetes-related complication having vision loss as a global concern, leading to substantial financial implications. ![]() 2 The national survey conducted in India establishes the prevalence of DM to be 11.2%. India ranks second in terms of disease burden globally with around 74.2 million individuals having diabetes. 1 According to International Diabetes Federation Atlas 2021, it was estimated that approximately 537 million individuals in the world had diabetes (types 1 and 2), aged between 20 and 79 years representing 10.5% of the world population. Keywords: neovascularisation, diabetic retinopathy, pan-retinal photocoagulation, vitrectomy, anti-VEGF, PDR in Indiaĭiabetes mellitus (DM) is one of the most common noncommunicable diseases in the world. The review also highlights the risk/benefit evaluation of the various approaches employed for PDR management in various clinical scenarios. The review emphasises current management approaches for PDR focusing on anti-VEGF therapy. Given the emerging role of anti-VEGF agents as a favourable adjunct or alternative therapy, they have a critical role in the management of PDR. Current management approaches for PDR have been stratified and involve pan-retinal photocoagulation, vitrectomy, and anti-VEGF agents. Various risk factors associated with PDR include hyperglycemia, hypertension, neuropathy, dyslipidemia, anaemia, nephropathy, and retinal complications of drugs used for diabetes. The advanced stage of DR or proliferative diabetic retinopathy (PDR) is of more concern, as it leads to vitreous haemorrhage and traction retinal detachment. ![]() It principally causes upregulation of pro-angiogenic, proinflammatory, and vascular permeability factors such as vascular endothelial growth factor (VEGF), leading to neovascularisation. Rajiv Raman, 1 Kim Ramasamy, 2 Utkarsh Shah 3ġShri Bhagwan Mahavir Vitreoretinal Services, Chennai, Tamil Nadu, India 2Aravind Eye Hospital, Madurai, Tamil Nadu, India 3Novartis Healthcare Private Limited, Mumbai, IndiaĬorrespondence: Rajiv Raman, Shri Bhagwan Mahavir Vitreoretinal Services, Chennai, Tamil Nadu, India, Tel +91-9444288708, Email Ībstract: Diabetic retinopathy (DR) is considered one of the leading causes of vision loss globally.
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