Diabetic retinopathy: modern epidemiological, pathogenetic, diagnostic, surgical aspects (review)

Objective: to present current data regarding the epidemiological, pathogenetic, diagnostic and surgical aspects of proliferative diabetic retinopathy (PDR). The review was performed using the Russian database RSCI and the international database PubMed, while the search keywords were "diabetic retinopathy", "proliferative diabetic retinopathy", "vitrectomy". A total of 478 sources were identified with further use of systematic review filters and authors' knowledge of the topic (43 sources were selected for review). The duration of the search was 10 years (2013-2022). Conclusion. A significant increase in the incidence of diabetes mellitus is accompanied by an increase in the incidence (up to 4% among people with diabetes) of PDR, which is one of the main causes of blindness and low vision in working age. The leading factors that determine the occurrence and pathogenesis of PDR are hyperglycemia, chronic inflammation, and changes in retinal blood flow. In the diagnostic plan, the value of optical coherence tomographic angiography is noted. The main directions of vitrectomy in PDR (optimization of surgical equipment, visualization of vitreoretinal structures, the use of drugs, the development of new technologies for surgical intervention) provide an increase in the clinical effectiveness of the treatment. The presented modern data should be taken into account when counseling patients about the tactics and duration of treatment for patients with PDR.