By Francesco Bandello, Marco Attilio Zarbin, Rosangela Lattanzio, Ilaria Zucchiatti
With the arrival of powerful remedies for diabetic retinopathy (DR), a brand new period within the administration of DR has been unfolded. Amid the deluge of authorized remedies and promising new concepts, even though, clinicians could locate it tough to settle on definitely the right perform in every one person case. the aim of this easy-to-use and richly illustrated guide is to help ophthalmologists in making judgements within the whole administration of DR in accordance with the easiest on hand proof. useful and whole thoughts are supplied to lead clinicians in prognosis, decision-making, and therapy. The guide comprises sensible algorithms and case histories when it comes to all levels of DR that sincerely clarify the development of the sickness and may aid the clinician to decide on the easiest healing strategy. it will likely be an incredible source for ophthalmologists aiming to supply optimum medical administration for this sight-threatening disease.
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Extra info for Clinical Strategies in the Management of Diabetic Retinopathy: A step-by-step Guide for Ophthalmologists
Hard exudates are yellow, cereus intraretinal lipids, usually deposed at the posterior pole, secondary to the fluid accumulation . Clinically they are organized in cluster and often assume the typical distribution of the circinate pattern surrounding one or more microaneurysms  (Fig. 6). When the location of the circinate is centered on the fovea, a macular star pattern is represented. The detection of hard exudates, usually at the border of an area of retinal thickening, is a marker of clinically significant diabetic macular edema and thus is often associated with a decreased visual acuity.
FA and OCT have a predominant role in more advanced stages and in the presence of diabetic maculopathy. 3 Present Therapies About 366 million people in the world are affected by diabetes mellitus (DM), a planetary health problem which incidence is growing quickly . Up to 25 % of diabetic patients develop diabetic retinopathy (DR) : this is a chronic, microvascular complication that can end in blindness. The patients with the highest possibility of developing diabetic retinopathy are those with long time disease and poor metabolic control.
According to this new scale, the DR was classified into five stages, based on the observable findings on dilated fundus ophthalmoscopy: no apparent DR, mild NPDR, moderate NPDR, severe NPDR, and PDR. 1 Classification of the severity of NPDR, modified from the DRS scheme Level of severity Very mild NPDR Mild NPDR Moderate NPDR (level 43) Moderate NPDR (level 47) Severe NPDR Very severe NPDR Visible findings on dilated fundus ophthalmoscopy Only microaneurysms Hard exudates, cotton wool spots, and/or mild intraretinal hemorrhages Divided in two levels of gravity A.