당뇨망막병증: 선별검사부터 치료까지

초록

Purpose: Diabetic retinopathy is one of the most common complications of diabetes mellitus and remains a leading cause of visual impairment worldwide. Because early-stage diabetic retinopathy is often asymptomatic, diagnosis is frequently delayed, resulting in progression to vision-threatening stages. This education column reviews the importance of screening, summarizes current diagnostic approaches, and outlines contemporary treatment strategies for diabetic retinopathy in routine clinical practice. Current concepts: Regular screening and timely ophthalmic referral are essential for the early detection of diabetic retinopa-thy. Fundus examination remains the cornerstone of diagnosis, while advances in retinal imaging—including ultra-widefield fundus photography, optical coherence tomography (OCT), fluorescein angiography, and OCT angiography—enable more precise assessment of disease severity, retinal ischemia, and macular involvement. Management strategies are determined according to disease stage and include systemic risk factor control, intravitreal injections, laser photocoagulation, and surgical intervention. Intravitreal anti–vascular endothelial growth factor therapy is the first-line treatment for diabetic macular edema, whereas panretinal photocoagulation remains the standard treatment for proliferative diabetic retinopathy. Discussion and conclusion: Diabetic retinopathy is a progressive disease; however, vision-threatening complications can be substantially reduced through early detection and appropriate management. Regular screening, accurate staging, and timely treatment are key elements in preventing severe visual loss. Close collaboration among primary care physicians, endocrinolo-gists, and ophthalmologists, together with continuous patient education, plays a critical role in improving screening adherence and clinical outcomes. A comprehensive, multidisciplinary approach is essential to reduce the burden of visual impairment caused by diabetic retinopathy. © Korean Medical Association.

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