Considering an upward global trend in cardiovascular disease rates, retinal vein occlusion (RVO) in particular, development of therapeutic guidelines is a pressing issue in ophthalmology. Risk factors for RVO include hypertension, atherosclerosis, diabetes mellitus, blood disorders, inflammatory disorders, and prescription drug use. Three stages of RVO have been identified. By location, the entity can be divided into three big groups: central retinal vein occlusion (CRVO), branch retinal vein occlusion (BRVO), and hemicentral retinal vein occlusion (HCRVO), each being either ischemic or nonischemic. Functional prognosis is better in nonischemic occlusions. Patient management comprises acute-stage treatment (anticoagulants, fibrinolytic agents, and hemodilution) and struggling with ocular complications (intravitreal injections and laser coagulation). It is essential that primary assessment and follow-up of patients at any stage of RVO include optical coherence tomography and fluorescent angiography.
Diabetes mellitus and diabetic retinal lesions are a global challenge for healthcare systems and one of the leading causes of severe vision loss among the working age population. Retinal laser coagulation remained the standard of therapy and the only possible treatment for diabetic macular edema (DME) in the 80-90s of the last century. The introduction of anti-VEGF therapy and glucocorticoids into the wide practice has significantly expanded the range of possibilities of DME treatment, allowing not only to stabilize patients vision, but also to improve it. The analyses of the large randomized clinical trials results are made and presented in this article, that highlight the basic principles of the contemporary DME treatment. This information is intended to help the ophthalmologist to develop the most optimal approach to treatment, considering the individual characteristics of each patient and the evidence-based efficacy and safety data of different methods.
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