Diabetes is a disease that can be treated with oral antidiabetic agents and/or insulin. However, patients' metabolic control is inadequate in a high percentage of them and a major cause of chronic diseases like diabetic retinopathy. Approximately 15% of patients have some degree of diabetic retinopathy when diabetes is first diagnosed, and most will have developed this microvascular complication after 20 years. Early diagnosis of the disease is the best tool to prevent or delay vision loss and reduce the involved costs. However, diabetic retinopathy is an asymptomatic disease and its development to advanced stages reduces the effectiveness of treatments. Today, the recommended treatment for severe nonproliferative and proliferative diabetic retinopathy is photocoagulation with an argon laser and intravitreal injections of anti-VEGF associated with, or not, focal laser for diabetic macular oedema. The use of these therapeutic approaches is severely limited, such as uncomfortable administration for patients, long-term side effects, the costs they incur, and the therapeutic effectiveness of the employed management protocols. Hence, diabetic retinopathy is the widespread diabetic eye disease and a leading cause of blindness in adults in developed countries. The growing interest in using polyphenols, e.g., resveratrol, in treatments related to oxidative stress diseases has spread to diabetic retinopathy. This review focuses on analysing the sources and effects of oxidative stress and inflammation on vascular alterations and diabetic retinopathy development. Furthermore, current and antioxidant therapies, together with new molecular targets, are postulated for diabetic retinopathy treatment.

ABSTRACT.Aims: To assess the safety and workload reduction of an automated 'disease/no disease' grading system for diabetic retinopathy (DR) within a systematic screening programme. Methods: Single 45°macular field image per eye was obtained from consecutive patients attending a regional primary care based DR screening programme in Valencia (Spain). The sensitivity and specificity of automated system operating as 'one or more than one microaneurysm detection for disease presence' grader were determined relative to a manual grading as gold standard. Data on age, gender and diabetes mellitus were also recorded. Results: A total of 5278 patients with diabetes were screened. The median age and duration of diabetes was 69 years and 6.9 years, respectively. Estimated prevalence of DR was 15.6%. The software classified 43.9% of the patients as having no DR and 26.1% as having ungradable images. Detection of DR was achieved with 94.5% sensitivity (95% CI 92.6-96.5) and 68.8% specificity (95% CI 67.2-70.4). The overall accuracy of the automated system was 72.5% (95% CI 71.1-73.9). Conclusions: The present retinal image processing algorithm that can act as prefilter to flag out images with pathological lesions can be implemented in practice. Our results suggest that it could be considered when implementing DR screening programmes.

PDT is a safe, long-term treatment for exudative age-related macular degeneration, but it is not definitive because this treatment cannot stop the initial growth of the choroidal neovascularization lesion.

Background: to compare the extent of the detached retina and retinal tears location in rhegmatogenous retinal detachment (RRD) among non-mydriatic ultra-wide field (UWF) imaging, dilated fundus exam (DFE), and intraoperative evaluation. Methods: this retrospective chart review comprised 123 patients undergoing surgery for RRD. A masked retina specialist analyzed the UWF fundus images for RRD area, status of the macula, and presence and location of retinal breaks. The same variables were collected from a database including DFE and intraoperative recordings. Evaluation methods were compared. Results: mean age was 59.8 ± 14.9 years. Best-corrected visual acuity improved from 0.25 ± 0.3 (Snellen) to 0.67 ± 0.3 at 12 months (p = 0.009). The RRD description and assessment of macula status (34.5% macula-on) did not differ between UWF, DFE, and intraoperative examination. The inferior quadrant was involved most frequently (41.5%), followed by the superior (38.9%), temporal (27.8%) and nasal quadrant (14.8%). Intraoperative exam detected 96.7% of retinal tears compared with DFE (73.2%, p = 0.008) and UWF imaging (65%, p=0.003). UWF imaging and DFE did not differ significantly. Conclusion: RRD extent on DFE and UWF images was consistent with intraoperative findings. UWF and DFE detection of peripheral retinal tears was similar, but 25% of retinal breaks were missed until intraoperative evaluation.

Combined, customized PDT + Bevacizumab therapy makes it possible to obtain visual results similar to those obtained in monotherapy, but with fewer intravitreal injections. It appears to be an interesting option for this type of patients.