MedWire News: The role of ophthalmologists must broaden to combat the increasing prevalence of diabetic eye diseases, which will involve them joining forces with other health care professionals involved in the management of Type 2 diabetes to help patients control their diabetes before eye complications worsen.
“By 2050, the number of Americans with diabetic retinopathy is projected to triple from 5.5 million to 16.0 million, and the number of those with vision-threatening retinopathy will increase from 1.2 million to 3.4 million,” write Thomas Gardner and Robert Gabbay (Penn State College of Medicine, Hershey, PA, USA) in an editorial in the Archives of Ophthalmology.
Despite this, there is currently no US Food and Drug Administration approved therapy for diabetic retinopathy; the only proven medical treatments are intensive diabetes therapy and control of hypertension.
The most effective way to stem the rising tide of diabetic retinopathy is to prevent it developing in the first place. However, the authors note, “the primary means to modify the course of diabetic eye diseases lie in the hands of nonophthalmic physicians.”
Management of late-stage eye disease fails to address the current public health problem. “Future efforts must focus on prevention and early intervention, and the role of ophthalmologists must evolve,” stress the authors.
Improved communication between ophthalmologists and other physicians will play an important role. For example, patients with retinopathy and higher glycated hemoglobin (HbA1c) and blood pressure levels are more likely to lose their vision than those with better control. To treat their patients more effectively, ophthalmologists therefore need to know the systemic health of their patients.
Small differences in systemic risk factors can lead to large differences in ocular complications. Each 1% reduction in HbA1c reduces the risk of retinopathy development or progression by 40%.
“Likewise, physicians should know the ophthalmic status of their patients so they can motivate them toward appropriate self-care measures,” write the authors.
Diabetic retinopathy is preventable. Better coordination of care between specialists and primary care teams will enable goals to be reinforced for patients with diabetes.
“Ophthalmologists have a unique opportunity to influence patient behavior because vision loss is one of the most feared complications of diabetes,” conclude the authors.
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