[Diabetic retinopathy. Current opinion on pathophysiology, diagnostics and therapy].

Diabetic eye disease affects quality of life for patients with diabetes by decreasing visual acuity and increasing the risk of blindness. In the course of diabetic retinopathy (DR) the loss of capillary integrity, microaneurysm formation, and ischemia is observed, which in turn drives the progression of DR. The macular edema is the result of fluid accumulation in the retina secondary to capillary leakage and/or microaneurysms. This contributes to loss of vision in DR. There is substantial evidence that control over metabolic factors can effectively prevent the development and progression of DR. For many patients who fail to achieve the optimal level of metabolic control the standard care should include the early detection and timely treatment of DR. Laser photocoagulation therapy, and vitrectomy are invasive methods, recommended to treat only the late stages of disease. A number of pharmacological agents that could slow the progression of DR in earlier stages are now being tested. It is likely that at least one of these agents, will be effective in reducing the progression of DR and the associated vision loss. With the introduction of these drugs in the coming years, there will be a need for improved screening and monitoring of patients with DR. New technologies are giving patients more access to optimal screening and may make this a more achievable goal.