Characteristic and management of proliferative process in patients with diabetic retinopathy
Lipatov D.V., Kuzmin A.G., Tolkacheva A.A., Chistyakov T.A.

Endocrinology Research Center, Moscow, Russia

Introduction: The Pandemic of diabetes worldwide has led to increasing incidence and changing patterns of eye damage in this disease. The emergence of new modern methods of diagnosis and treatment of diabetic retinopathy does not reduce the number of eye complications this type in patients with diabetes mellitus. This is due to the fact that the proliferative process in diabetic retinopathy has become more variable – growth of proliferative tissue can be seen not only in the posterior segment of the eye, but also in other structures of the eyeball. All this makes it extremely difficult to timely diagnosis, delay the starting time of treatment and, ultimately, worsens the prognosis of the disease.
Objective: The aim of this work was the generalization of the data variants of the course of the proliferative process in diabetic retinopathy and modern methods of its treatment. 
Material and methods: The study centered on patients with proliferative diabetic retinopathy from different regions of the Russian Federation, held examination and treatment in the Department of "Diabetic retinopathy and ophthalmic surgery" Endocrinology Research center in 2011-2015 inclusive. 
Results and discussion: "posterior" proliferation was detected in 2,000 patients (6,9% of all patients with diabetes). One of the most effective methods of its treatment remains the retina laser coagulation (RLC). It can stabilize the process in 70-75% of cases even in patients with proliferative stage of disease. If pathological process was restricted the focal RLC has been performed. "Anterior" proliferation, according to our data, in most cases (80%) begins on pupillary edge of the iris. In 20% of cases - from the anterior chamber angle and then centrifugally to the edge of the pupil. The newly-formed blood vessels cross the ciliary body and the scleral spur, which was observed in 200 patients (0,07%) in our study, and only 81 of them (0,03%) required drainage surgery. We detected only 2 cases of “intermedium” proliferation (0,007%). The growth of new vessels on the anterior hyaloid membrane of the vitreous is probably possible only in case of its pathological changes.
Conclusion: The Extension of our knowledge about types of the course of the proliferative process in diabetic retinopathy allows us to diagnose pathological changes in the eye and timely treatment. All of this can contribute to a more optimistic prognosis of the disease.

Key words: diabetes mellitus, diabetic retinopathy, neovascular glaucoma, proliferative process.

For citation: Lipatov D.V., Kuzmin A.G., Tolkacheva A.A. et al. Characteristic and management of proliferative process in patients with diabetic retinopathy. // RMJ. Clinical ophthalomology. 2016. № 2. P. 107–111.