1. Glossophobia

6. Fluctuating vision

8. Endothelial Cells & Pericytes

9. Stages of diabetic retinopathy
Nonproliferative diabetic retinopathy.
Diabetic Macular Edema.
Proliferative diabetic retinopathy (PDR).
Hemorrhages, fibro-vascular scaring and ischemia.

11. Nonproliferative retinopathy

12. Diabetic Macular Edema.

13. Proliferative diabetic retinopathy (PDR).

17. Laser and Sugar Diabetic Retinopathy Study (DRS- 1976)
Early Treatment Diabetic Retinopathy Study (ETDRS -1979)
Diabetic retinopathy vitrectomy study (DRVS-1989)
The Diabetes Control and Complications trial (DCCT-1993)
Action to Control Cardiovascular Risk in Diabetes (ACCORD-2009)

18. PRP Laser

19. The Diabetes Control and Complications trial (DCCT-1993)
The study showed: keeping blood glucose levels as close to normal as possible slows the onset and progression of the eye, kidney, and nerve damage caused by diabetes.
Eye disease 76% reduced risk
Kidney disease 50% reduced risk
Nerve disease 60% reduced risk

20. Action to Control Cardiovascular Risk in Diabetes (ACCORD-2009)
Glucose control: Intensive blood sugar control reduced the progression of diabetic retinopathy compared with standard blood sugar control.
Cholesterol control: combination lipid therapy with a fibrate and statin also reduced disease progression compared with statin therapy alone.
Blood pressure: Intensive blood pressure control provided no additional benefit to patients compared with standard blood pressure control.
WHAT!!...” intensive blood sugar control to near normal glucose levels increased the risk of death (22% higher) and severe low blood sugar, so patients and their doctors must take these potential risks into account when implementing a diabetes treatment plan.”

21. Paradigm Shift – Anti-VEGF
DRCR.net
Protocol I: For DME which is better? Lucentis (anti-VEGF), Laser, or Steroid.
Protocol T: For DME which is Anti-VEGF better Which anti VEGF is better? Lucentis, Avastin, Eyelea
Protocol S: For PDR which is better Laser or Avastin (Anti-VEGF)