History of Diabetic Eye Related Diseases

Diabetes mellitus is the number one cause of blindness among adults aged 20 - 64 in the United States. The Center for Disease Control estimates that 9.4% of the US population meets diagnostic criteria for diabetes. Among patients with the disease, over one-fourth will have findings of diabetic retinopathy, ranging from mild non-proliferative diabetic retinopathy (rare dot-blot hemorrhages) to the most severe form, proliferative diabetic retinopathy (PDR). Despite diabetes being recognized as a unique disease entity as early as the 2nd century AD, no physician was capable of identifying the connection between this mysterious endocrine disorder and its ocular manifestations until the 19th century, mainly due to limitations in the ocular examination. As imaging modalities have developed over the decades of research, so have our various treatments; which now include a wide range of options such as anti-VEGF injections, laser treatment, and microsurgeries. Here we review the evolution of imaging modalities, pathophysiology of proliferative vs. non-proliferative diabetic retinopathy complications, and commonly used treatment options.