New approaches in the detection and management of diabetic retinopathy in the near future

Diabetes mellitus (DM), a group of metabolic diseases characterized by hyperglycemia, is a major public health problem worldwide. In recent years, the incidence and prevalence of DM has been increasing as a global epidemic. Diabetic retinopathy (DR) is the most common complication of DM and remains the major cause of preventable blindness among working-age people in most developed countries and it has a significant socioeconomic impact and source of morbidity. DR, which has long been recognized as a microvascular disease, has been demonstrated by laboratory and clinical evidence that inflammation and retinal neurodegeneration may also contribute to diabetic retinal damage in the early stages of DR. New diagnostic and treatment modalities in DR management is promising. Further elucidation of the underlying molecular mechanisms may provide new medical approaches for the development of novel therapeutic modalities. Nowadays, novel diagnostic devices such as ultrawide field fundus fluorescein angiography, optic coherence tomography angiography and adaptive optics retinal imaging have improved the detection of DR earlier, faster and more accurately. Subthreshold micropulse laser and other laser photocoagulation applications may be an alternative to conventional retinal photocoagulation with lower complications for DR treatment. In recent years, artificial intelligence, machine learning, and deep learning based diagnosis and treatment applications are developing. In addition, in recent years, unmanned automated-based diagnostic and treatment methods and newly developed intravitreal drugs and implants can offer more diagnostic and treatment options with promising results. This review provides an overview of novel diagnostic and treatment approaches for preventing the progression of diabetic retinopathy.