Diabetic retinopathy has become an important problem that endangers the visual health of our diabetic population. What is the incidence of diabetic retinopathy? How should it be treated and prevented? During the 2015 CDS Annual Meeting, Medical World interviewed Professor Zhang Xinyuan of Beijing Tongren Hospital and Beijing Institute of Ophthalmology, a well-known specialist in fundus disease. The Medical World: Hello Professor Zhang, first of all, thank you very much for the interview with The Medical World. As a very familiar expert in the field of diabetes and ophthalmology, can you tell us about the current incidence of diabetic retinopathy in China? Professor Zhang Xinyuan: Diabetic retinopathy is the most serious ocular complication caused by diabetes. It is a series of typical lesions caused by abnormal glucose metabolism resulting in damage to retinal microvasculature and neurons, and is a chronic and progressive blinding fundus disease. It is mainly characterized clinically by vision loss, fundus hemorrhage, exudation, macular edema, and proliferative lesions. A meta-analysis of 35 well-known international epidemiological studies (22,896 diabetics) showed that the global prevalence of diabetic retinopathy is 34.6%, and the prevalence in China is about 27-43%. In China, diabetic retinopathy is characterized by “four highs and one low”, i.e., high prevalence, high blindness, high prevalence, high socioeconomic burden, and low awareness rate. Therefore, diabetic retinopathy has become a serious social and public problem in China that endangers the visual health of our people. Medical World: You often participate in international academic exchanges in the ophthalmology profession, can you tell us whether there are any significant differences in the treatment of diabetic retinopathy at home and abroad at present? Prof. Zhang Xinyuan: With the popularity of the Internet and the increasing ways of information exchange, domestic and international knowledge updates on diabetic retinopathy are basically in sync. Currently, China also has its own guidelines for diabetic retinopathy, and the relevant guidelines from the US, EU and UK are also used as references and supplements for guidance in clinical work, and the international influence of domestic experts is constantly increasing. Medical World: As a research scholar, what is your recent research or opinion on the pathogenesis and treatment of diabetic retinopathy? Prof. Zhang Xinyuan: International large-scale population-based cross-sectional studies have provided very important evidence-based evidence for the prevention and treatment of diabetic retinopathy. For example, the DCCT study, UKPDS study, ACCORD, FILED study, ETDRS study and so on. In addition, well-designed international RCTs such as the famous DRCR. Net Diabetic Retinopathy Research Network in the United States have also provided ophthalmologists with important recommendations on treatment strategies for diabetic retinopathy and diabetic macular edema. Because the pathogenesis has not been elucidated, current basic research is focused on the pathogenesis of diabetic retinopathy. In addition, we propose the use of gene therapy to enhance the current therapeutic space and to save patients’ vision to the maximum extent possible. What do you think is the difference in the concept of prevention and treatment of diabetic retinopathy between endocrinologists and ophthalmologists? Prof. Zhang Xinyuan: The current treatment philosophy of both sides is the same, and they both recognize that they should work together to fight the important public health problem of diabetic retinopathy. The country proposes to move forward in the prevention and treatment of major diseases, and the prevention and treatment of diabetic retinopathy requires more involvement of endocrinologists. The prevention and treatment system of diabetes advocates tertiary prevention, and the prevention of diabetic complications should also go one step further. Experts from both sides should work together to control risk factors when there are no complications and try to prevent complications from occurring. Medical World: How should diabetic retinopathy be prevented? How can early treatment be carried out? Prof. Zhang Xinyuan: According to the guidelines on diabetic retinopathy in China, the United States and the European Union, patients should be educated and made aware of the possibility of diabetic retinopathy as soon as they are diagnosed with diabetes, especially type II diabetes. Therefore, there is a need to improve the management of diabetic patients at the national and public health levels first. At the current grand annual meeting of the CDS, I have personally benefited from the presentations of major diabetes experts who are also calling for increased patient education on the complications of diabetes. Therefore, education and health management for diabetic patients is an important part of our joint efforts. In addition, I am also engaged in the research of biological markers, and we hope to find some biological markers in the development of diabetes or even in the high-risk group, and find the cytokines with early warning effect to intervene, so as to treat patients earlier and more precisely, which is also an important direction for the effective prevention of diabetic retinopathy. Medical World: Regarding the pharmacological treatment of non-proliferative diabetic retinopathy, calcium hydroxybenzenesulfonate (e.g. Cogon) is a drug with indications, can you introduce the drug for the treatment of diabetic retinopathy? Prof. Zhang Xinyuan: Calcium hydroxybenzenesulfonate (such as cortisone you just mentioned) was included in the European Pharmacopoeia as early as 1997 and in the British Pharmacopoeia in 1998. Diabetic retinopathy is one of the indications for its treatment. In a study on the efficacy of calcium hydroxybenzenesulfonate, we searched the Pubmed, SpringLink, and Cochrane Library databases for randomized controlled trials, and among 128 randomized controlled studies (RCTs), 8 RCTs with a rigorous design were selected based on strict entry criteria. It can treat non-proliferative diabetic retinopathy systemically (lowering whole blood viscosity, plasma viscosity, and blood cholesterol) and locally (protecting the blood retinal barrier, improving retinal microangiomas, and reducing retinal hemorrhage and exudation). Regarding the pharmacological treatment of diabetic retinopathy, especially for non-proliferative diabetic retinopathy, it is really felt that more evidence-based evidence is yet to be supported in clinical work. Prof. Xin-Yuan Zhang presented “Prevention and treatment of diabetic retinopathy – endocrinologist? Ophthalmologists? at the 2015 CDS Annual Meeting.