Abstract

DO.01.08

Diabetic retinopathy – relevance of treatable risk factors

Spital G., Pauleikhoff D.
Department of Ophthalmology, St. Franziskus-Hospital, Münster

Objective: Despite recent therapeutic options diabetic retinopathy (dr) still remains the leading cause of legal blindness in working age population in the western world. How could the risk for a diabetic retinopathy be reduced according to current knowledge and which of the treatable risk factors are of relevance in our patients?
Methods: In a cross sectional study of 968 consecutive diabetic patients in our tertiary retinological centre we tried to identify possible influenceable risk factors for a DR by analyzing a standardized anamnesis, blood-pressure and hba1c levels and the stage of diabetic retinopathy. Results and conclusions are discussed in the context of a current literature survey.
Results: In accordance to the current literature our results show that glycemic exposure, indicated by the hba1c value, remains the most relevant risc factor for DR. In addition a history of arterial hypertension and particularly an increased systolic pressure have a significant impact on risk of DR and macular edema. Currently, a prophylactic use of antihypertensive drugs (ACE inhibitor/AT II-blocker) even in absence of arterial hypertension is evaluated (`direct study` etc.). Hyperlipidaemia, adiposity and smoking are of minor relevance as risk factors for DR, but some lipid lowering drugs seem to have an intrinsic preventive capacity for DR beyond their usual effects (`field study`).
Conclusions: Good control of hyperglycemia and hypertension remains the most important instrument in reducing the risk for DR. Former established target values of these risk factors are currently re-evaluated and some antihypertensive and lipid lowering drugs could play a role in preventing DR even in patients with otherwise well controlled risk factors.

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