ABSTRACT
Retinopathy is one of the most dreaded complications of diabetes because blindness is a greater fear than loss of a limb or death (www.lionsclubs.org/EN/content/ news news release58.shtml). Fortunately, advances in the control of blood pressure, hyperglycemia, and hyperlipidemia have reduced the risk of visionthreatening retinopathy in persons with diabetes in each of the succeeding decades from the 1960s to the 1990s (1,2). Nevertheless, the number of persons with diabetes is expected to double by the year 2030 particularly in the developing world (3,4), so fundamentally new approaches are urgently needed to prevent more visually impaired persons, particularly in countries with limited access to medical care. Diabetic retinopathy has been viewed from a surgical perspective and ophthalmologists have employed destructive photocoagulation using halogen light or laser sources for 50 years (5). Photocoagulation remains the primary treatment for diabetic retinopathy in the 21st century. It effectively reduces the risk of blindness but is destructive, expensive, and can be uncomfortable. Its mechanism of action is similar to that of gamma radiation for tumors; i.e., to destroy diseased tissue. Photocoagulation does not address the metabolic processes that lead to the development retinopathy and vision loss. Many patients are reluctant to undergo the treatment, and those who have already loss vision often do not fully regain their sight.
