Les complications rétiniennes du diabète sont fréquentes et graves car elles conduisent volontiers à la malvoyance. Elles associent un versant ischémique par occlusion capillaire et un versant œdémateux par anomalie de la perméabilité vasculaire. Leur dépistage est essentiel pour optimiser la prise en charge des facteurs de risque et/ou instaurer un traitement spécifique.

Diabetic retinopathy and diabetic macular edema, two major ophthalmological complications due to diabetes mellitus, are the consequences of microangiopathy. In addition to usual mechanisms of alterations of vascular walls, other factors seem to be involved such as inflammation or oxidative stress. Many factors affect the onset of these two complications or their rhythm of progression. Among those, some of them must be mentioned: anteriority of the diabetes, glycemic balance and metabolic memory, systemic high blood pressure, sleep apnea… Diabetic retinopathy and macular edema are classified according to the retinal abnormalities observed during the fundus examination or by OCT. The different stages of these classifications allow determining the ophthalmological follow up rhythm. Before the occurrence of diabetic retinopathy, screening for these retinal complications is based ophthalmological follow up or on non-mydriatic retinal imaging networks. The treatment of diabetic retinopathy is still based on pan retinal photocoagulation, and the one of macular edema is increasingly based on intra vitreous injections of antiangiogenic agents.