Diabetic eye disease is a public health concern in all areas of the world as a leading cause of blindness in the working aged to elderly populations. Diabetes damages the lining of the microvasculature throughout the body through prolonged exposure to hyperglycemic conditions. The ocular changes are progressive with very little recourse for improvement once damage begins. Current treatments for the eye focus mainly on the late stages of the disease when neovascularization or edema threatens sight. Early interventions for diabetic vasculopathy involve metabolic therapy to improve blood glucose and blood pressure control. Technology improvements have a large part to play in advancing diagnosis of diabetic eye disease. These new technologies offer both structural and functional means for assessment of retinal health. This review focuses on current treatments for diabetic eye disease at all stages with an emphasis on new and early interventions. It also details established and emerging technologies used for earlier detection of diabetic eye disease, which is vital to the development and approval of much needed treatments targeted at earlier stages of diabetic retinopathy. Possible future treatments should be aimed to prevent retinal vasculopathy from progressing. This review will explore current research on this topic and what is needed moving forward.
Corneal nerve density in the sub-basal plexus decreased with increasing myopia. This could have implications for corneal surgery and contact lens wear in this patient population.
The optimal SD-OCT scan technique depends on the ocular condition being imaged. High-density scan techniques require longer acquisition time but may enhance the detection of focal retinal pathology.
Neuro-ophthalmic disease can cause a wide array of visual impairments. Management should include neuro-ophthalmic examination, patient education regarding visual prognosis, and evaluation of visual function. Often, low vision examination and rehabilitation are useful adjuncts to the neuro-ophthalmic evaluation. Components of a low vision examination pertaining to neuroophthalmology are discussed. Specific low vision management strategies are reviewed for patients with visual acuity loss, visual field loss, decreased contrast sensitivity, and ocular motor disturbances caused by neuro-ophthalmic disease.
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