Editing Diabetic retinopathy (section)

==Research==
Several large multicenter randomized clinical trials have been done to evaluate treatment protocols for those with diabetic retinopathy, namely the Early Treatment for Diabetic Retinopathy Study, Diabetic Retinopathy Vitrectomy Study,  Diabetic Retinopathy Study, Diabetes Control and Complications Trial, UK Prospective Diabetes Study, and the Diabetic Retinopathy Clinical Research Network Protocols I, S, and T.{{sfn|Brownlee|Aiello|Sun|Cooper|2020|loc="Monitoring and treatment of diabetic retinopathy"}}

=== Light treatment ===
A medical device comprising a mask that delivers green light through the eyelids while a person sleeps was under development in 2016.<ref name=Sivaprasad2016>{{cite journal | vauthors = Sivaprasad S, Arden G | title = Spare the rods and spoil the retina: revisited | journal = Eye | volume = 30 | issue = 2 | pages = 189–192 | date = February 2016 | pmid = 26656085 | pmc = 4763134 | doi = 10.1038/eye.2015.254 }}</ref><ref>{{Cite web|title=Noctura 400 Sleep Mask for diabetic retinopathy|url=https://www.io.nihr.ac.uk/report/noctura-400-sleep-mask-for-diabetic-retinopathy/|access-date=2022-02-15|website=NIHR Innovation Observatory}}</ref> The light from the mask stops [[rod cells]] in the retina from [[Adaptation (eye)#Dark adaptation|dark adapting]], which is thought to reduce their oxygen requirement, which in turn diminishes new blood vessel formation and thus prevents diabetic retinopathy.<ref name=Sivaprasad2016/>  As of 2016 a large clinical trial was underway.<ref name=Sivaprasad2016/> As of 2018, the results from the clinical trial showed no long-term therapeutic benefit from using the mask in diabetic retinopathy patients.<ref>{{Cite web| vauthors = Powell S |title=No "long-term therapeutic benefit" from £250 mask|url=https://www.aop.org.uk/ot/science-and-vision/research/2018/03/16/no-long-term-therapeutic-benefit-from-250-mask|access-date=2022-02-15|website=www.aop.org.uk|language=en}}</ref>

===C-peptide===
[[C-peptide]] had shown promising results in treatment of diabetic complications incidental to vascular degeneration.<ref>{{cite journal | vauthors = Bhatt MP, Lim YC, Ha KS | title = C-peptide replacement therapy as an emerging strategy for preventing diabetic vasculopathy | journal = Cardiovascular Research | volume = 104 | issue = 2 | pages = 234–244 | date = November 2014 | pmid = 25239825 | doi = 10.1093/cvr/cvu211 | doi-access = free }}</ref> Creative Peptides,<ref>{{cite web|title=C-peptide - Creative Peptides -|url=http://adisinsight.springer.com/drugs/800010430|publisher=AdisInsight|access-date=22 October 2016}}</ref> Eli Lilly,<ref>{{cite web|title=C-peptide – Eli Lilly|url=http://adisinsight.springer.com/drugs/800005551|publisher=AdisInsight|access-date=22 October 2016}}</ref> and Cebix<ref>{{cite web|title=C-peptide long-acting – Cebix|url=http://adisinsight.springer.com/drugs/800034107|website=adisinsight.springer.com|publisher=AdisInsight|access-date=22 October 2016}}</ref> all had [[drug development]] programs for a C-peptide product. Cebix had the only ongoing program until it completed a Phase IIb trial in December 2014 that showed no difference between C-peptide and placebo, and it terminated its program and went out of business.<ref>{{cite news| vauthors = Bigelow BV |title=Cebix Shuts Down Following Mid-Stage Trial of C-Peptide Drug|url=http://www.xconomy.com/san-diego/2015/02/23/cebix-shuts-down-following-mid-stage-trial-of-c-peptide-drug/|work=Xconomy|date=23 February 2015}}</ref><ref>{{cite news| vauthors = Garde D |title=Cebix hangs it up after raising $50M for diabetes drug|url=http://www.fiercebiotech.com/r-d/cebix-hangs-it-up-after-raising-50m-for-diabetes-drug|work=FierceBiotech|date=February 24, 2015}}</ref>

===Stem cell therapy===
Clinical trials are under way or are being populated in preparation for study at medical centers in Brazil, Iran and the United States. Current trials involve using the patients' own stem cells derived from bone marrow and injected into the degenerated areas in an effort to regenerate the vascular system.<ref>{{cite web| vauthors = Ljubimov A |title=Stem Cell Therapy for Diabetic Retinopathy|url=http://isopt.net/wp-content/uploads/2013/11/Ljubimov_Stem-Cell-Therapy-for-Diabetic-Retinopathy.pdf|publisher=Cedars-Sinai Medical Center, Regenerative Medicine Institute, Los Angeles, CA, USA Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA|access-date=2014-12-30|archive-url=https://web.archive.org/web/20141230085623/http://isopt.net/wp-content/uploads/2013/11/Ljubimov_Stem-Cell-Therapy-for-Diabetic-Retinopathy.pdf|archive-date=2014-12-30|url-status=dead}}</ref>

===Blood pressure control===
A [[Cochrane (organisation)|Cochrane review]] examined 29 randomized controlled trials to determine whether interventions that sought to control or reduce blood pressure in diabetics had any effects of diabetic retinopathy.<ref name=":5">{{cite journal | vauthors = Do DV, Han G, Abariga SA, Sleilati G, Vedula SS, Hawkins BS | title = Blood pressure control for diabetic retinopathy | journal = The Cochrane Database of Systematic Reviews | volume = 2023 | issue = 3 | pages = CD006127 | date = March 2023 | pmid = 36975019 | pmc = 10049880 | doi = 10.1002/14651858.CD006127.pub3 }}</ref> While the results showed that interventions to control or reduce blood pressure prevented diabetic retinopathy for up to 4–5 years in diabetics, there was no evidence of any effect of these interventions on progression of diabetic retinopathy, preservation of visual acuity, adverse events, quality of life, and costs.<ref name=":5" />

=== Fundoscopic image analyses ===
[[File:Image processing figure.jpg|thumb|Distribution in percentage of pre-processing techniques from 2011 to 2014<ref name=":2"/>]]
Diabetic retinopathy is diagnosed entirely by recognizing abnormalities on retinal images taken by fundoscopy. Color fundus photography is mainly used for staging the disease. Fluorescein angiography is used to assess the extent of retinopathy that aids in treatment plan development. Optical coherence tomography (OCT) is used to determine the severity of edema and treatment response.<ref>{{Cite news|url=http://www.merckmanuals.com/professional/eye-disorders/retinal-disorders/diabetic-retinopathy|title=Diabetic Retinopathy|newspaper=Merck Manuals Professional Edition|access-date=2016-11-13}}</ref>

Because fundoscopic images are the main sources for diagnosis of diabetic retinopathy, manually analyzing those images can be time-consuming and unreliable, as the ability of detecting abnormalities varies by years of experience.<ref name=":1">{{Cite journal| vauthors = Kaur M, Talwar R |year=2014|title=Review on: Blood Vessel Extraction and Eye Retinopathy Detection|journal=International Journal of Computer Science and Information Technologies|volume=5|issue=6|pages=7513–7516}}</ref> Therefore, scientists have explored developing [[computer-aided diagnosis]] approaches to automate the process, which involves extracting information about the blood vessels and any abnormal patterns from the rest of the fundoscopic image and analyzing them.<ref name=":2">{{Cite book| vauthors = Ahmad A, Mansoor AB, Mumtaz R, Khan M, Mirza SH |title=2014 5th European Workshop on Visual Information Processing (EUVIP) |chapter=Image processing and classification in diabetic retinopathy: A review |date=2014-12-01|pages=1–6|doi=10.1109/EUVIP.2014.7018362|isbn=978-1-4799-4572-6|s2cid=16465894}}</ref>