Medical management of diabetic retinopathy

Medical management is focused on the proven benefit of tight glucose and blood pressure (BP) control. Standard management includes multiple cardiovascular risk factor management with angiotensin receptor blockade, statin, and fibrate treatment. Targets to achieve include HbA1c <7% (53 mmol/mol), BP <140/80, and serum cholesterol <4 mmol/L. A number of large recent trials have specifically demonstrated the beneficial effects on diabetic retinopathy (DR) of angiotensin receptor blockade (the DIRECT study) and fenofibrate (the fenofibrate intervention and event lowering in diabetes [FIELD] and action to control cardiovascular risk in diabetes [ACCORD] eye studies).