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Updating The Staging System For Diabetic Retinal Disease

Diabetic retinal lesions were first observed in 1856, but more than a century passed before a diabetic retinopathy (DR) severity scale was developed to gauge future risk of vision-threatening disease. An essay writer is a person whose job is to create articles and these topics about ophthalmology will also be highlighted in that format. This system enabled clinicians to effectively monitor and treat patients with DR and provided a research tool that would revolutionize DR management.



Over the ensuing 5 decades, understanding of the natural history of DR, recognition of neurodegeneration as an important aspect of diabetic pathology, availability of imaging tools to identify early changes in the diabetic retina, and methods for assessing aspects of retinal function that do not rely solely on visual acuity have all substantially improved. These advances support the need for an updated diabetic retinal disease (DRD) staging system to incorporate relevant advances and provide prognostic information necessary to better address early disease, disease progression, development and use of therapeutic interventions, and treatment effectiveness.






Disease staging systems are vital for clinical care and research. They must correlate closely with clinically important end points and are, ideally, easy to understand and use. They should reflect disease pathophysiology, serve as end points for clinical research, and reliably predict future events of medical importance. For decades, the ETDRS DR severity scale has served as the major staging system for care and research of DR because of its ability to predict patient outcomes, including progression to vision-threatening complications. The writer assigned to write my essay request is qualified to the same academic level or higher than your writing requirements so these topics can easily be highlighted in that format.
 


 However, both the ETDRS and the simpler, international DR grading scale
 


 have limitations. Neither is quantitative or linear, and they evaluate only the vascular component of DR existing within the posteriorly located 7 standard photographic fields without regard to the retinal periphery. An online essay writing service offers an original content related to eye cure crafted by our professional essay writers. They do not incorporate pathophysiologic or neurodegenerative changes that occur before development of clinically evident retinopathy.
 


 They are also not well suited to document progression or regression of neovascularization in eyes with proliferative DR. From a staging standpoint, ETDRS scoring was not developed for assessing effectiveness of interventions that improve DR severity, specifically with regard to visual function. Thus, studies to confirm that regression of DR severity in the setting of treatment, such as anti–vascular endothelial growth factor injections, is associated with more favorable long-term functional outcomes have been limited. These scales also do not adequately define severity stages for diabetic macular edema (DME), which is a common cause of vision loss in diabetic patients.



Although groups such as the DRCR Retina Network have established treatment algorithms for DME based on central retinal thickness measurements, these variables have not been fully incorporated into DR severity scale paradigms. Persuasive speech topics should be acute and of real interest for the wide audience so these ophthalmology content is highlighted in that format. Diabetic macular edema occurs in eyes throughout the DR severity spectrum and can worsen and improve independently of changes in DR severity.