Team of the Clinic of Ophthalmology of the Medical Centre of Postgraduate Education presents further issues, which we cope with in every day practice. The principal subject of this bulletin is a diabetes mellitus, which is currently defined by WHO as the epidemic of the 21^st century.

The paper regarding epidemiology and pathogenesis of the diabetes mellitus has summarized recent statistical data related to morbidity and incidence of the diabetes mellitus. Differences in pathogenesis of type 1 and type 2 diabetes mellitus were presented as well as recent reports regarding role of the cytokines in the development of insulin resistance. The authors emphasize influence of the genetic and environmental factors in the development of this disease. One of the most significant problems related to the diabetes mellitus is the diabetic retinopathy. Content of a presented article describes its pathogenesis in details and it helps to understand this issue.

Within the study conducted in the Clinic of Ophthalmology of the Medical Centre of Postgraduate Education we conducted diagnostics of the diabetic macular edema in forty patients with diabetes mellitus using RTA ( retinal thickness analyzer). The authors emphasized non-invasive nature of the exam, simple operation of the device and easy evaluation of the exam results. For these reasons, the method may play an important role as the screening towards the macular edema in patients with diabetes. It has been established that the retina in the area of the fovea and in the area of the posterior pole is statistically significantly thicker in the group of patients with diabetes than it is in the control group.

The angiography and the optical coherence tomography are the exams, which are necessary in the diagnostics of the diabetic lesions in the eye fundus, which is the subject of presented paper. These are techniques that allow evaluation of the retino-choroidal circulation. The basis for observed angiographic lesions in the diabetic retinopathy includes so called microangiopathy [microvascular disease], loss of the pericytes, thickening of the vascular basement membrane, proliferation of the endothelial cells and changes in blood composition – erythrocytes and platelets. The angiography allows defining type of the diabetic retinopathy, evaluating advancement, efficacy of used therapy, evaluating diabetic maculopathy. Introducing the optical coherence tomography – OCT as non-contact, non-invasive imaging method was the beginning of the new era in the diagnostics and treatment of the retinal diseases. OCT also provides the high sensitivity in detection of the clinically significant macular edema amounted to 89% and specificity – 96%.

The article regarding laser therapy describes photocoagulation, which is necessary in treatment of the diabetic reticulopathy and complications of the proliferative reticulopathy. The pan retinal photocoagulation allows stopping or obtaining regression of the vascular neoplasia in the retina, the optic disc or the iris. We use focal photocoagulation in the clinically significant macular edema and it includes guided photocoagulation of the microaneurysms in the macula. The grid photocoagulation is conducted in the diffuse diabetic macular edema. At the same time, the authors indicate that efficacy of the laser therapy in the diabetes depends on suitable control of the general parameters by a patient.