Guías de práctica clínica de la SERVManejo de las complicaciones oculares de la diabetes. Retinopatía diabética y edema macular

  1. A. Pareja-Ríos
  2. M.A. Serrano-García
  3. M.D. Marrero-Saavedra
  4. V.M. Abraldes-López
  5. M.A. Reyes-Rodríguez
  6. F. Cabrera-López
  7. M. López-Gálvez
  8. P. Cardona-Guerra
  9. P. Abreu-Reyes
  10. E. Quijada-Fumero
  11. A. Coronado-Toural
  12. E. Gutiérrez-Sánchez
  13. M.A. Gil-Hernández
  14. P. Valls-Quintana
  15. R. Navarro-Alemany
  16. Marín Olmos, F.
Revue:
Archivos de la Sociedad Española de Oftalmologia

ISSN: 0365-6691

Année de publication: 2009

Volumen: 84

Número: 9

Pages: 429-450

Type: Article

DOI: 10.4321/S0365-66912009000900003 DIALNET GOOGLE SCHOLAR lock_openAccès ouvert editor

D'autres publications dans: Archivos de la Sociedad Española de Oftalmologia

Résumé

Objetivo: La diabetes mellitus está considerada como la causa más frecuente de ceguera en la población activa en los países industrializados, siendo el edema macular diabético la causa más frecuente de disminución de la agudeza visual y la retinopatía diabética proliferante la responsable de los déficit visuales más severos. Por ello hemos intentado establecer una guía de actuación clínica cuyo propósito es proporcionar unas directrices que sirvan de orientación para el tratamiento de la retinopatía diabética y sus complicaciones. Esto se hace necesario en un momento en el que han aparecido numerosas alternativas terapéuticas cuyo papel aún no está completamente definido. Método: Un grupo de expertos retinólogos seleccionados por la SERV han evaluado los resultados publicados sobre las distintas opciones terapéuticas que existen en la actualidad, en base a lo cual se sugieren líneas de actuación según el grado de retinopatía diabética que presenta el paciente y la presencia o no de edema macular. Resultados: El tratamiento princeps de la RDP es la panretinofotocoagulación (PFC). El tratamiento de elección en el edema macular diabético clínicamente significativo sin signos de tracción vítreo macular continúa siendo la fotocoagulación focal/rejilla. La cirugía retinovítrea tiene así mismo sus indicaciones en ambas afecciones. Se discute el uso de fármacos antiangiogénicos. Conclusión: La laserterapia es efectiva en el manejo de la RD y del EMD. El papel de los antiangiogénicos aún no está suficientemente definido.

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