The Role of Dyslipidemia Control in the Progression of Diabetic Retinopathy in Patients with Type 2 Diabetes Mellitus.

Diabetic retinopathy (DR) is a common microvascular complication of diabetes mellitus (DM) and is considered as the leading cause of visual impairment in working-aged adults worldwide. Dyslipidemia has been associated with DR, but not with progression to the proliferative form of DR, although the exact role in the pathogenesis of DR and diabetic macular edema (DME) remains controversial. As a result, a reasonable question arising is whether control of dyslipidemia may alter the course of DR. Statins do not appear to have an impact on DR progression. On the other hand, fenofibrate has been found to significantly reduce the rate of progression of DR in patients with pre-existing mild DR, although it has no impact on patient's vision nor on the prevention of DR development in patients with type 2 DM without DR. An interesting point that needs further evaluation is why patients without DR or those with severe DR appear to have no benefit from fenofibrate treatment.