Diabetic retinopathy is disease of an eye, which mainly occurs because of diabetes. Diabetic retinopathy develops due to damage of retinal vessels of the light-sensitive tissue at the back of the eye. Diabetic retinopathy is most likely to develop among people who have either type first or second of diabetes. Although diabetic retinopathy does not always cause severe pain, it can result in blindness. There are several forms of retinopathy:
In its early forms, diabetic retinopathy is almost always painless and patient might not even notice loss of vision. As disease progresses, a person can develop intraocular hemorrhage, accompanied by appearance of veil in front of the eye and strange dark spots, which disappear after some time. Massive vitreous hemorrhage can lead to complete loss of vision. Macular edema can also cause an appearance of veil in front of an eye. It can become difficult to work with small objects or read.
As it was mentioned before, DR is caused by diabetes. It happens because excessive amount of sugar in blood destroys certain vessels that bring nourishment and blood supply to retina. Without these vessels eye start to develop its own blood vessels, but they can not work as effectively as proper ones did, and then there is leakage, which destroys retina.
Also people who do not check their blood sugar level regularly can develop diabetic retinopathy. In rare cases high blood pressure and pregnancy can also cause DR.
Diagnosis is usually done during simple examination of diluted pupils to examine the state of retina. Usually, he uses special drops that can significantly dilate pupils. These drops can cause blurring of vision, but it always wears off after several hours. Strange new blood vessels or swelling of retina can indicate that a patient has diabetic retinopathy. Some abnormalities in optic nerve can also indicate presence of DR. Angiography helps to make a picture of an eye and assess its state for any changes in its structure. Tomography can also show pictures of an eye and it also determines the thickness of retina.
If a person had diabetes, it`s important to conduct careful monitoring of blood glucose levels, blood pressure and renal function. New studies showed that conventional therapy and intensive management of diabetes reduces probability of DR appearance by 74% and occurrence of proliferative retinopathy - by 57%.
Laser treatment. In progressive stages of diabetic retinopathy most patient need to undergo laser treatment to restore functionality of the retina. Laser treatment is more preferable than surgery, as it can be performed on an outpatient basis and it also has less complication. Laser treatment mainly aims to destruct areas of retinal hypoxia, which is a source of newly-formed blood vessels that cause retina leakage. Laser can also increase direct entry of oxygen from retina choroid and provide thermal coagulation of newly formed blood vessels to protect them from spreading and causing vision problems.
For diabetic retinopathy treatment laser can be applied throughout all parts of retina, excluding only its central parts. The newly-formed blood vessels undergo focal laser irradiation. This surgical method is especially highly effective in early treatment and cure rate is almost 100%. In severe cases effectiveness of laser treatment is reduced. If a person has diabetic macular edema laser exposures of central parts of retina can also be applied. Long-term treatment effects are largely determined by the stage of diabetes and by extent of damage that excessive blood sugar level causes to eyes.
Surgery. Surgical treatment, also called vitrectomy, is required, if there was massive intraocular hemorrhage or if proliferative retinopathy caused significant decrease of vision. During vitrectomy an eye surgeon removes blood clots from eye cavity. If possible, he also removes the back of hyaloid membrane which is located between retina and vitreous body. This hyaloid membrane does not play any important role in eye function, but it can cause the development of proliferative retinopathy.
Conservative therapy. Patient with diabetic retinopathy is recommended to spend much time sitting with closed eyes. This simple method facilitates bleeding of vessel thrombosis. If there was a sufficient increase of optical media transparency after conservative treatment, laser treatment is required. If there was no increase of transparency, he may need to undergo vitrectomy. Drug therapy for diabetic retinopathy is one of the most controversial areas in modern ophthalmology, as it presents many contradictions that still need to be solved. On one hand, there was a large number of studies, that continue to actively search for new therapeutic agents. On the other hand, there are no pharmacological agents, whose safety in treatment of DR was proved. That`s why drugs are used very rarely for DR treatment. Usually conservative treatment, coagulation, laser and surgery are enough to eliminate diabetic retinopathy.
Most patients who suffered from diabetes more than 10-12 years have some form of retinal lesion problem. Careful monitoring and assessment of glucose levels, dietary restrictions and healthy lifestyle can reduce risk of blindness by several times. However, the most effective preventive measure for people with a long-term diabetes is regular examination at an ophthalmologist.Hide
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