edited by Harry W. Flynn, Jr, MD, and William E. Smiddy, MD, 334
pp, with illus, $115, ISBN 1-56055-173-9, San Francisco, Calif, The Foundation
of the American Academy of Ophthalmology, 2000.
Though the title of this monograph suggests that it focuses only on
therapies, it also provides an excellent review of pathogenesis, epidemiology,
diagnostic imaging, and nonretinal abnormalities. Therapies discussed go beyond
laser photocoagulation and vitrectomy surgery. Issues such as glycemic control
and blood pressure control are addressed, as well as the role of aspirin and
experimental medical therapies. This book also tackles the difficult management
of cataract surgery with concurrent diabetic retinopathy. Mitchell Fineman,
MD, and William Benson, MD, review some of the medical literature regarding
issues such as extracapsular cataract extraction vs phacoemulsification, position
of intraocular lens placement (sulcus vs endocapsular), the role of combined
surgery (vitrectomy and cataract surgery), and the role of posterior capsulotomy.
Though the authors do not always give specific recommendations regarding these
issues, this is mainly a reflection of the lack of sound medical evidence
for or against various interventions. Nevertheless, to assist in the management
of such patients, 2 decision trees are provided at the conclusion of the chapter.
The editors have carefully selected authors for each section, and each author
is appropriately assigned to specific topics. For example, Lloyd Paul Aiello,
MD, and Thomas Gardner, MD, concisely outline the pathogenesis of diabetic
retinopathy in the first chapter, and potential future noninvasive, nondestructive
medical therapies in the last chapter. Frederick Ferris III, MD, is the lead
author of the chapter that reviews past clinical studies on the treatment
of diabetic retinopathy. Harry Flynn, MD, and William Smiddy, MD, speak to
the role and techniques of vitrectomy. Ronald Klein, MD, and Barbara Klein,
MD, give an in-depth discussion on the epidemiology of eye disease in diabetes.
George Blankenship, MD, gives the reader a history lesson on the first steps
toward treating diabetic retinopathy. Text is supplemented with easily understood
colorful graphs, tables, and figures. The text concludes with an appendix,
which provides a synopsis of diabetic retinopathy clinical trials, including
the Diabetic Retinopathy Study, the Early Treatment Diabetic Retinopathy Study,
the Diabetic Retinopathy Vitrectomy Study, the Diabetes Control and Complications
Trial, and the United Kingdom Prospective Diabetes Study. This is a well-organized,
well-written, and sufficiently comprehensive text that is easy to understand.
Both the general ophthalmologist and the retina specialist will find this
a very useful text.
Aaberg TM. Diabetes and Ocular Disease: Past, Present, and Future Therapies (Ophthalmology Monographs, No. 14). Arch Ophthalmol. 2001;119(7):1088. doi: