Media Type: Textbook (Hardcover)

Synopsis: In addition to the life-changing consequences of vision loss as a complication of diabetes, there has been good evidence that the presence of diabetic ocular disease serves as a risk indicator for death from vascular diseases in this patient population. There has been a vast body of published literature from clinical experiences to basic science research on the topic of diabetic retinopathy that has the potential of being overwhelming. Drs. Scott, Flynn, and Smiddy have done an outstanding job in bringing together the leaders in the field to compile this easy to read amalgamation of the most up-to-date research on the pathophysiological mechanisms contributing to diabetic retinopathy, the clinical experience as well as diagnostic and therapeutic approaches for this disease. A “must-read” for all ophthalmologists and general practitioners who treat patients with diabetes.

Target Audience: Ophthalmologists who manage patients with diabetes.

Review: The second edition of the monograph is a valuable and comprehensive collection of chapters, which encompasses currently available ideas on diabetic ocular disease with all its complexities and recent advances, garnered from research in the last decade. Coming on the heels of the first edition published in 2000, it appropriately builds on old ideas, describes the logic and evidence for treatment strategies being used in the present, and speculates on novel treatments for the future.

The chapters are well-organized starting with an overview of the worldwide diabetes epidemic and weaving its way through current classification schemes for the disease, histopathology, and pathogenesis, as well as epidemiology and risk factors of diabetic retinopathy. A chapter on the history of evolving treatments for diabetic retinopathy from photocoagulation to vitreous surgery makes for interesting reading and is appropriately followed by a series of chapters on diagnostic and therapeutic approaches in the management of this disease. A new chapter on the use of telemedicine for diabetic retinopathy is not only timely and comprehensive, discussing the research and validation of telemedicine, but also provides guidelines for setting up a telemedicine program to improve ophthalmic surveillance of at-risk diabetic patients, which is especially useful in medically under-served communities around the world. An excellent chapter on future therapies discusses the rationale and status of anti-angiogenic and anti-permeability interventions with a thoughtful treatise on the potential challenges for treating with anti-VEGF and other anti-angiogenic therapies. The inclusion of abstracts of major multicenter trials for diabetic retinopathy will be of interest to most ophthalmologists making decisions about treatments for their patients.

As is usual in the case of multi – authored books, there is some redundancy in the material presented although not excessively so. There is an easy flow between chapters that makes for easy reading.

In summary, this book is at present the most comprehensive practical reference guide for the screening, diagnosis and management of ocular complications in patients with diabetes. Any ophthalmologist working with diabetic patients and seeking a broad background in the understanding of the principles of diagnosis and management of diabetic retinopathy and risk reduction would benefit significantly from the wealth of information contained in this monograph.