DIABETIC RETINOPATHY WITH A FOCUS ON DIAGNOSTIC AND THERAPEUTIC ADVANCES AND FACTORS ASSOCIATED WITH CLINICAL PROGRESSION

Abstract

Diabetic retinopathy is one of the main microvascular complications of diabetes mellitus and represents a significant cause of visual impairment and preventable blindness in adults. It is a multifactorial condition whose progression is associated with the interaction of metabolic, inflammatory, neurodegenerative factors, as well as aspects related to access and continuity of care. This study aimed to critically analyze the scientific evidence regarding factors associated with the progression of diabetic retinopathy, focusing on diagnostic and therapeutic advances. This is an integrative literature review conducted in accordance with PRISMA 2020 guidelines. The search was performed in PubMed/MEDLINE, LILACS, SciELO, Web of Science, and the Virtual Health Library, using DeCS descriptors combined with Boolean operators. Original and review studies addressing risk factors, diagnosis, and treatment of diabetic retinopathy were included, totaling 19 studies in the final sample. Data analysis was performed descriptively and interpretatively. The findings showed that disease progression is associated with poor glycemic control, inflammatory processes, oxidative stress, molecular alterations, and low adherence to clinical follow-up. Advances in early diagnosis through imaging techniques and artificial intelligence, as well as the development of biomarkers and new therapeutic approaches, were highlighted. It is concluded that diabetic retinopathy presents a complex progression, requiring integrated strategies involving early diagnosis, individualized treatment, and continuous care.