Taraprasad Das MD
Director Smt. Kanuri Santhamma Retina and Vitreous Centre LV Prasad Eye Institute,
LV Prasad Marg Banjara Hills Hyderabad, India
Alka Rani MD
Smt. Kanuri Santhamma Retina and Vitreous Centre LV Prasad Eye Institute,
LV Prasad Marg Banjara Hills Hyderabad, India
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Jaypee Brothers Medical Publishers (P) Ltd
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Foundations in Vitreoretinal Diseases: Diabetic Eye Diseases
© 2006, Taraprasad Das, Alka Rani
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the authors and the publisher.
First Edition : 2006
9788180618406
Typeset at JPBMP typesetting unit
Printed at Gopsons Papers Ltd, Sector 60, Noida
To Savitri and Shilpa
—TD
To My Parents and Patients
—AR
7Contributors
- Subhabrata Chakrabarti, phd
- Scientist, Kallam Anji Reddy Molecular
- Genetics Laboratory
- LV Prasad Eye Institute
- LV Prasad Marg, Banjara Hills
- Hyderabad – 500 034
- G Chandra Sekhar, md
- Director
- Education Centre, and VST Centre for
- Glaucoma Care, LV Prasad Eye Institute
- LV Prasad Marg, Banjara Hills
- Hyderabad – 500 034, India
- E-mail: gcs@lvpei.org
- Taraprasad Das, md
- Director
- Smt. Kanuri Santhamma Retina and
- Vitreous Centre, LV Prasad Eye Institute
- LV Prasad Marg, Banjara Hills
- Hyderabad – 500 034, India
- Undurti N Das, md
- President and CEO
- UND Life Sciences, USA
- Chief
- Dept. of Molecular and Clinical Medicine
- Care Institute of Medical Sciences
- Hyderabad, India
- Koilkonda R Devi, msc
- Kallam Anji Reddy Molecular Genetics
- Laboratory, LV Prasad Eye Institute
- LV Prasad Marg, Banjara Hills
- Hyderabad – 500 034
- Amod Gupta, ms
- Dept. of Ophthalmology
- Postgraduate Institute of Medical
- Education and Research
- Chandigarh – 160 012
- Anjli Hussain, ms
- Consultant
- Smt. Kanuri Santhamma Retina and
- Vitreous Centre, LV Prasad Eye Institute
- LV Prasad Marg, Banjara Hills
- Hyderabad – 500 034, India
- Nazimul Hussain
- Consultant
- Smt. Kanuri Santhamma Retina and
- Vitreous Centre, LV Prasad Eye Institute
- LV Prasad Marg, Banjara Hills
- Hyderabad – 500 034
- Subhadra Jalali, ms
- Consultant
- Smt. Kanuri Santhamma Retina and
- Vitreous Centre, LV Prasad Eye Institute
- LV Prasad Marg
- Banjara Hills
- Hyderabad – 500 034, India
- Inderjeet Kaur, phd
- Scientist
- Kallam Anji Reddy Molecular Genetics
- Laboratory, LV Prasad Eye Institute
- LV Prasad Marg
- Banjara Hills
- Hyderabad – 500 034
- Sarfaraz A Khan, md
- Director, Vision Rehabilitation Centres
- LV Prasad Eye Institute
- LV Prasad Marg, Banjara Hills
- Hyderabad – 500 034, India
- Sreelatha Komatireddy, msc
- Kallam Anji Reddy Molecular Genetics
- Laboratory, LV Prasad Eye Institute
- LV Prasad Marg, Banjara Hills
- Pankaj Maheshwari, ms
- VST Centre for Glaucoma Care
- LV Prasad Eye Institute
- LV Prasad Marg, Banjara Hills
- Hyderabad – 500 034
- Ajit B Majji, md
- Consultant
- Smt. Kanuri Santhamma Retina and
- Vitreous Centre, LV Prasad Eye Institute
- LV Prasad Marg, Banjara Hills
- Hyderabad – 500 034, India
- Somasheila I Murthy
- Consultant
- Cornea and Anterior Segment Service and
- Ophthalmic Pathology Service
- LV Prasad Marg, Banjara Hills
- Hyderabad – 500 034, India
- Praveen K Nirmalan, mph
- Consultant
- International Centre for Advancement of
- Rural Eye Care, Kismatpur Campus
- Post Bag No.1, Kismatpur BO
- Rajendra Nagar Post, Hyderabad – 500 030
- Avinash Pathengay, ms
- Consultant
- Smt. Kanuri Santhamma Retina and
- Vitreous Centre, LV Prasad Eye Institute
- LV Prasad Marg, Banjara Hills
- Hyderabad – 500 034, India
- LS Mohan Ram, dot
- Smt. Kanuri Santhamma Retina and
- Vitreous Centre, LV Prasad Eye Institute
- LV Prasad Marg, Banjara Hills
- Hyderabad – 500 034, India
- Balasubramanya Ramamurthy, md
- Consultant
- Cornea and Anterior Segment Services
- LV Prasad Eye Institute
- LV Prasad Marg, Banjara Hills
- Hyderabad – 500 034
- K Ramesha, ms
- Consultant
- Jasti V Ramanamma Children's Eye Care
- Centre, LV Prasad Eye Institute
- LV Prasad Marg, Banjara Hills
- Hyderabad – 500 034
- Alka Rani, md
- Smt. Kanuri Santhamma Retina and
- Vitreous Centre
- LV Prasad Eye Institute LV Prasad Marg
- Banjara Hills
- Hyderabad – 500 034
- B Venkateshwara Rao, md
- Consultant
- Jasti V Ramanamma Children's Eye Care
- Centre, LV Prasad Eye Institute
- LV Prasad Marg, Banjara Hills
- Hyderabad – 500 034
- S Saravanan, mhm
- Director-Administration
- International Centre for Advancement of
- Rural Eye Care, Kismatpur Campus
- Post Bag No.1
- Kismatpur BO
- Rajendra Nagar Post
- Hyderabad – 500 030
- Pravin K Vaddavalli, ms
- Consultant
- Cornea and Anterior Segment Services
- LV Prasad Eye Institute
- LV Prasad Marg, Banjara Hills Hyderabad – 500 034
- Geeta K Vemuganti
- Director
- Ophthalmic Pathology Service and Head Stem Cell Laboratory
- LV Prasad Marg, Banjara Hills
- Hyderabad – 500 034
Diabetic retinopathy is one of the major causes of blindness and has become the leading cause in the 21st Century. Until now, there has been no comprehensive book on diabetic retinopathy.
The authors have covered all aspects of diabetic retinopathy in a detailed, but understandable manner for the general ophthalmologist and retinal specialists. They have combined their own wealth of experience and included the most recent up-to-date advancements in the field in a single comprehensive volume. This book should be read and included in the library of every ophthalmologist around the world.
Prof Suresh Chandra
University of Wisconsin
11Preface
Diabetes and diabetic eye diseases are on rise. The current estimate of nearly 33 million diabetics in India is predicted to rise to 55 million in year 2020 and to 80 million by year 2025. It is hence pertinent that we know the basic facts and treatment of diabetic eye diseases.
Diabetes is a complex multifactorial disease. Progressive retinopathy is the cause of visual loss in patients with diabetes mellitus though; nearly structures of the eye get affected. This book compiles the current information from leading ophthalmologists and physicians regarding both diabetes and the associate eye diseases. All information put in the book is based on the evidence collected over years in medical literature. We have not listed the currently evolving treatment strategies that are undergoing clinical trials such as use of PKC β inhibitors, and intravitreal corticosteroid, and anti VEGF therapy. The emphasis has been on elaborating the accepted standard of care.
The book has 15 chapters and deals with all aspects of diabetic retinopathy including the primary disease (Diabetes mellitus, Chapter 1), treatment options (Medical care, Laser, and Surgery, Chapter 8), rehabilitation (Chapter 13) and the important clinical trials (Chapter 15). We have included case reports wherever required. The book is adequately illustrated and provided with easy-to-read tables, and box-information.
Many others worked for this book, but are not listed in the authors list. Mrs. S Banu along with the retina fellows, Rajeev Jain, Sikander Lodhi, Hema Rawal and Nishant Taneja corrected and formatted the references; Mr. SBN Chary and Mrs. K Sumasri selected relevant photographs; Mr. Koteswar and Mr. Rajendra Kumar helped format the text and figures and finally Mrs. Durga Dhanraj helped in the style editing. We are grateful to them, so also to all contributing authors who withstood the pressure of time and other work commitments to complete the job on time.
Taraprasad Das
Alka Rani