الفهرس 
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Abstract
Diabetes mellitus (DM) is a very dangerous health problem.
Diabetic retinopathy (DR) is one of the important complications of
diabetes. It is one of the most important causes of vision loss worldwide
,and is the principle cause of vision impairment in patients between 25
and 74 years of age. Visual loss from diabetic retinopathy may be
secondary to macular edema, hemorrhage from new vessels retinal
detachment or neovascular glaucoma.
The risk factors for DR are degree of glycaemic and blood pressure
control, duration of diabetes, presence of nephropathy and raised serum
lipids. Elevated lipid levels may be an additional risk factor for diabetic
macular oedema (DME) which is the most threatening complication of
DR, due to the deposition of hard exudates in the retina.
Dyslipidemia appears to play a more significant role. So, serum
lipid levels have a significant effect on the severity of retinal hard
exudates. As the density of these hard exudates increases, they tend to
migrate towards the fovealcentre where their deposition predisposes to
development of sub-foveal fibrosis leading to irreversible visual loss.
Also, it has a direct role in development of clinically significant macular
edema (CSME).
LASER treatment is most effective when initiated before visual
acuity is lost from diabetic macular oedema (DME).This emphasizes the
need for diligent monitoring a follow up care. Various studies over years
have suggested a relationship between serum lipid levels and DR.
This study was carried on 80 patients with diabetic macuolopathy and
hyperlipidemia patients who came to Menoufiya University Hospital and
Kafer El-sheikh ophthalmology hospital for evaluation and management
of diabetic retinopathy (DR) from April 2015 to March 2016 .
High serum triglycerides have shown to be associated with
increasd risk of development and progression of retinopathy.
Lowering serum lipids has shown a benifit on both proliferative
diabetic retinopathy and maculopathy beside their lipid lowering effect.
Some lipid lowering agents like, fibrates and statins extensively tested for
diabetic patients with retinopathy and proven a good efficacy.
Preservation of good vision and healthy cardiovascular system may be a
motivating factor for lowering serum lipids.