Diabetic Retinopathy: Current Treatment and Thailand Perspective.

Diabetes mellitus is a common and chronic metabolic disorder involving multiple organ systems. Major eye involvements include diabetic macular edema (DME) and proliferative diabetic retinopathy (PDR). With a significantly increasing global number of cases of diabetes and the tendency towards an aging population, sight-threatening diabetic retinopathies are expected to increase from 37.3 million in 2011 to 56.3 million worldwide by 2030. Besides good glycemic and metabolic disease control, appropriate diabetic retinopathy (DR) screening and prompt treatments are crucial in order to minimize visual impairment from DR. The first-line therapy of DME is anti-vascular endothelial growth factor while panretinal photocoagulation laser remains the main treatment for PDR. Fortunately, in Thailand, these conditions have been included in the fundamental rights to eye care treatment, though an extension of geographic coverage and equal accessibility to care is needed. The Ministry of Public Health of Thailand has recently launched an area health initiative named the Service Plan, integrating 13 centers of excellence for certain specialties. As one of the 13 specialties, ophthalmic care includes centers of excellence in retina diseases. The policy implementation is aimed at drastically reducing preventable visual impairment resulting from various retinal diseases.