| [ Summary ] |
Over the past few decades, the management of diabetic retinopathy has been dramatically improved. Current diabetic retinopathy treatment is oriented not only toward saving patients from blindness but also at obtaining better quality of vision. Recently, the visual prognosis for diabetic retinopathy patients undergoing hemodialysis has been improved by the timely use of laser photocoagulation and sophisticated vitrectomy techniques. Improvements in hemodialysis techniques such as hemodynamic monitoring and the availability of recombinant erythropoietin have also inhibited deterioration of retinal function, resulting in better visual prognosis. Proliferative diabetic retinopathy at the initiation of hemodialysis is known to stabilize within a few years. Today, most diabetic retinopathy with end stage renal disease is considered to improve after the induction of hemodialysis. Induction of hemodialysis is thus advocated to stabilize neovascular proliferation and resolve macular edema in severe diabetic retinopathy. Recognition of the stage and severity of diabetic retinopathy is necessary to initiate hemodialysis appropriately. A team approach such as timely referral of patients for ophthalmological intervention is a key in saving patients from blindness. |