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Medical management of diabetic retinopathy 

Medical management of diabetic retinopathy
Chapter:
Medical management of diabetic retinopathy
DOI:
10.1093/med/9780199544967.003.0016
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date: 18 September 2019

Medical management is focused on the proven benefit of tight glucose and blood pressure control.

Standard management includes multiple cardiovascular risk factor management with angiotensin receptor blockade, statin and fibrate treatment in addition to aspirin.

Targets to achieve include HbA1c <7%, blood pressure <140/80, and serum cholesterol <4mmol/l.

A number of new trials have demonstrated the beneficial effects on diabetic retinopathy (DR) of fenofibrate (lipid lowering), and Ruboxistaurin ® (protein kinase C inhibition) with reduction of laser treatment and protection of vision.

A landmark study of an angiotensin receptor blocker is due to complete shortly (DIRECT study) which will provide data on the potential benefit of this treatment on both primary and secondary prevention of DR.

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