Diabetic retinopathy (DR) is a leading cause of preventable vision impairment and blindness in the European Region. Despite the fact that almost all European countries have some kind of prophylactic eye examination for people with diabetes, the examinations are not properly arranged and are not organized according to the principles of screening in medicine. In 2021, the current COVID-19 pandemic moved telemedicine to the forefront healthcare services. Due to that, a lot more patients could benefit from comfortable and faster access to ophthalmology specialist care. This study aimed to conduct a narrative literature review on current DR screening programs and registries in the European Union for the last 20 years. With the implementation of telemedicine in daily medical practice, performing screening programs became much more attainable. Remote assessment of retinal pictures simultaneously saves countries time, money, and other resources.

Diabetic alteration of the retinal microenvironment causes damage to the retinal vessels. Biomarkers such as vessel density and perfusion density, measured using optical coherence tomography angiography (OCT-A), may help detect early signs of diabetic retinopathy (DR) and track disease progression. In our study, we categorized 212 individuals into 2 groups: Group I (75 healthy individuals) and Group II (137 people with diabetes). All participants underwent comprehensive eye examinations, including OCT-A with AngioPlex™ system. The measurements taken of the superficial retinal capillary plexus included vessel and perfusion density. Our findings showed that vessel and perfusion densities in the central, inner, and outer ETDRS fields, as well as the full macular area, decreased with age. Notably, vessel and perfusion densities in the inner, outer, and full ETDRS macular areas in diabetic patients with mild DR were significantly lower, compared to those in healthy subjects. In conclusion, this study emphasizes the importance of vessel and perfusion densities as biomarkers for early diabetic retinopathy. However, it is important to note that their reduction does not precede clinical signs of diabetic retinopathy.

Microstructural analysis of retinal macular thickness and vasculature in healthy individuals using optical coherence tomography (OCT) and OCT-Angiography

Introduction: Diabetes mellitus (DM) is a group of diseases characterized by hyperglycemia due to an absolute or relative lack of insulin production or action. Extreme organ dysfunction, caused by chronically elevated blood glucose levels, affects the heart, kidneys, nervous system and retina. Aim: The aim of this article is to compare the macular retinal thicknesses and volume in patients with DM with and without mild diabetic retinopathy (DR) and healthy eyes. Materials and Methods: The people studied, 212 in total, were divided into three groups—healthy controls, diabetics without DR, and diabetics with a mild DR. In our study the ZEISS CIRRUS HD-OCT device was used as well as the Macular Cube 512x128, Macular Thickness Analysis, and Ganglion Cell Analysis protocols were used. We analyzed the thickness of the retina from the inner limiting membrane to the retinal pigment epithelium, as well as the thickness of the ganglion cell layer, and the inner plexiform layer in the macula. Results: A statistically significant difference between the groups was found for the mean and the minimum thickness of the ganglion cell + inner plexiform layer. No significant difference in mean values between patient groups for mean macular cube retinal thickness, foveal retinal thickness, and macular cube volume was found. Conclusion: There is no loss of ganglion cells and a decrease in the thickness of the inner layers of the retina in the macula that precedes the appearance of retinal microvascular damage, and the two processes occur simultaneously.