New guidelines for the management of diabetic retinopathy

diabetic retinopathy

How diabetic retinopathy manifests itself Diabetic retinopathy is an ophthalmological disease that develops against the background of diabetes mellitus. The consequences of this disease are very severe, with a neglected condition, blindness occurs. How to recognize the first signs of pathology? Let’s consider the degree of diabetic retinopathy and the existing methods of its treatment. What is diabetes? Diabetic retinopathy is an ophthalmic disease that develops against the background of diabetes mellitus diabetes Is a disease of the endocrine system, in which the permissible level of sugar (glucose) in the blood increases. This condition is called hyperglycemia. In this article, What is diabetes?

What is diabetic retinopathy?

What happens to vision in diabetic retinopathy? Stages of diabetic retinopathy Signs of diabetic retinopathy What factors can trigger retinopathy in diabetes? Diagnosis of diabetic retinopathy Treatment of diabetic retinopathy Occurs because the body does not produce enough insulin for diabetes. Insulin is a hormone that is synthesized by the beta cells of the pancreas. They respond to high glucose levels and send a certain amount of insulin to reduce its level in the blood. With diabetes, the metabolism of all types is disrupted: carbohydrate, water-salt, protein, and others. In recent years, there has been a steady increase in the number of patients with diabetes. In Russia, more than 3.7 million people were registered in 2019. patients with this diagnosis. However, according to the International diabetes Federation, the actual number of patients reaches 12 million. Half of the patients do not even know about their disease. But if it is not treated in time, it leads to serious health consequences. One of them is diabetic retinopathy. What is diabetic retinopathy? This pathology is one of the most severe complications of diabetes. It occurs in 90% of patients. With the development of the disease, undesirable substances begin to enter the retinal tissue, as the capillary walls become more permeable. At the initial stages of the disease, a person does not feel any manifestations. At the initial stages of the disease, a person does not feel any symptoms When the doctor sees severe changes in the fundus when examining the devices, a patient with diabetes may not experience any discomfort at all. Meanwhile, the disease progresses. The deterioration of vision is noticeable already with macular edema, or in the late stages of proliferative canadian retinopathy. This is why only early diagnosis and timely therapy are the basis for preventing the occurrence of blindness in diabetes mellitus. Modern devices for the study of eye structures allow you to get a complete picture of the state of the eyes.

What happens to vision in diabetic retinopathy? The retina is a very complex and sensitive structure of the eye. It consists of 10 layers and contains light-sensitive photoreceptors-rods and cones responsible for color, day and twilight vision. It is not surprising that any pathology of the retina leads to negative consequences for eye health. In the presence of diabetes, visual functions begin to suffer only after a few years, when diabetic retinopathy passes into the second and third stages. Here are the symptoms: “flies” in the eyes — blurring, especially noticeable on a light background; blurred image, double vision; incorrect perception of the shape and size of objects, their color, curvature of straight lines; the appearance of” lightning ” and flashes in the eyes; in the field of vision appear scotomas, or blind areas, that is, fragments of the visible image fall out. In patients with diabetes, compared with healthy people, the risk of complete vision loss is as much as 25 times higher! No wonder diabetic retinopathy is the second leading cause of blindness in the world. It is also one of the main factors leading to disability and vision loss among the population at the most able-bodied age — from 25 to 65 years. In patients with diabetes mellitus, the risk of complete vision loss is as much as 25 times higher. the Decrease in visual acuity in diabetic retinopathy occurs for three main reasons. Due to macular edema or macular ischemia, Central vision is affected. Hemorrhages in the retina or vitreous body contribute to a sharp deterioration in the sharpness of vision. Usually this condition occurs with proliferative retinopathy.

The growth and contraction of connective tissue leads to retinal detachment, resulting in vision loss. Stages of diabetic retinopathy in the course of the disease there are three stages, adopted by who in 1992: non-proliferative, or initial; preproliferative; proliferative. 2. Preproliferative. In the second stage of retinopathy in diabetes mellitus, which often develops in patients suffering from myopia, the signs of damage to the inner eye membrane are more noticeable. There is a moderate deterioration in visual acuity. Due to oxygen starvation of the retina, there is a risk of hemorrhagic heart attack. There is also a large number of blood clots in the retina. 3. Proliferative. At the third stage, proliferative, as a result of a violation of the blood supply to the retina, its extensive lesion occurs with the spread of the pathological process to the cornea. Neovascularization and the formation of fibrous tissue develops. The walls of new vessels are very fragile, so blood seeps through them, causing repeated hemorrhages that contribute to retinal detachment.

Due to newly formed vessels of the iris, secondary glaucoma often develops. Macular edema becomes pronounced and can lead to partial loss of vision. The patient becomes difficult to read, small objects are almost indistinct, and the outlines of objects become indistinct. There is also a fourth stage-terminal, when the damage in the retina is already irreversible. This is the last stage of retinopathy, which is diagnosed in 2% of cases. In such situations, the patient becomes blind.


Douglas Badenoch
I am an information scientist with an interest in making knowledge from systematic research more accessible to people who need it. This means you. I've been attempting this in the area of Evidence-Based Health Care since 1995. So far the results have been mixed. For some reason we expected busy clinicians to search databases and appraise papers instead of seeing patients. We also expected publishers to make the research freely available to the people who paid for it.. Ha! Hence The National Elf service.

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