Weak evidence for radix astragali in treating diabetic retinopathy

Weak evidence for radix astragali in treating diabetic retinopathy

Diabetic retinopathy is an ophthalmic disease that develops against the background of diabetes. The consequences of this disease are very severe, with a neglected condition, blindness occurs. How to recognize the first signs of pathology? Let’s look at 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 is Due to the fact that the body does not produce enough insulin for diabetes. Insulin is a hormone that is synthesized by 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 patients with this diagnosis were registered in 2019. 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 retinopathy. That is why only early diagnosis and timely therapy are at the heart of preventing the occurrence of blindness in diabetes. Modern devices for studying eye structures allow you to get a complete picture of the eye condition. 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, daytime 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 several years, when diabetic retinopathy passes into the second and third stages. Here are the symptoms there are: “floaters” in the eyes of the haze, especially noticeable on a light background, blur, double vision; perception of shape and size of objects, their color, curved lines; the emergence of “lightning” and flashes in the eyes; in the field of view appear scotoma, or blind areas, that is, have the fragments of the visible image.

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, 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. Central vision is affected by macular edema or macular ischemia. Hemorrhages in the retina or vitreous body contribute to a sharp deterioration in the sharpness of vision. This condition usually occurs with proliferative retinopathy. The growth and contraction of connective tissue leads to retinal detachment, resulting in vision loss. Stages of diabetic retinopathy during the course of the disease there are three stages, adopted by who in 1992: non-proliferative, or initial; preproliferative; proliferative. Sistein Ultra Plus 10 ml 560 RUB Sistein Ultra 3 ml 300 RUB Oftylla 15 ml 560 RUB Each of them has its own symptoms. Let’s take a closer look at what they are expressed in. 1. Nonproliferative. The first stage of diabetic retinopathy is characterized by spot hemorrhages, microaneurysms that occur due to fragility and fragility of blood vessels, exudative foci, macular edema of the retina. At the same time, for several years, vision may remain stable, and the patient will not suspect that he has a disease. 2. Preproliferative. In the second stage of retinopathy in diabetes mellitus, which often develops in patients suffering from myopia, signs of damage to the eye’s inner shell 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 damage 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.

Because of newly formed iris vessels, secondary glaucoma often develops. Macular edema becomes pronounced and can lead to partial loss of vision. It becomes difficult for the patient to read, small objects are almost indistinct, and the outlines of objects become indistinct. There is also a fourth stage-terminal, when damage to 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. Signs of diabetic retinopathy in the first and often second stages of the disease, the patient may not notice any manifestations of the disease. Only at the third, proliferative stage, do the first signs of pathology make themselves felt: deterioration of twilight vision (night blindness), blurring, distortion of the outlines of objects. This is why if you have type 1 or type 2 diabetes, checkups with an optometrist should be mandatory-at least once every six months. With the help of devices, the doctor will see changes in the fundus, when the patient himself will not experience any discomfort. Early diagnosis is very important for successful treatment of the disease. Symptoms of diabetic retinopathy usually occur one after another in a certain order: the lumen of the vessels expands, T-leukocytes stick to the foci of inflammation; metabolic disorders lead to an increase in blood flow; the endothelium of blood vessels is affected; capillaries become clogged, their permeability increases; microaneurysms are formed (protrusion of the walls of blood vessels and capillaries); neovascularization occurs — the growth of capillaries in those areas where they should not be; hemorrhages begin in the eye, since the walls of newly formed vessels are very fragile and cannot withstand the pressure of increased blood flow; part of the capillaries is destroyed, and degeneration of the eye vessels occurs.

These processes gradually lead to the increasing occurrence of hemorrhages, oxygen starvation of the retina, macular edema and gradual tissue degeneration. What factors can trigger retinopathy in diabetes? In the presence of this disease, the patient needs to be extremely careful about the state of their health. Many factors can trigger the progression of diabetic retinopathy. Elderly people need to be examined even more often than 2 times a year, since senile changes also occur in the eyes at this time, which in combination can lead to a significant deterioration of vision. prolonged hyperglycemia, when the blood sugar level is higher than normal for a long time But age is not the only factor that increases the risk of diabetic retinopathy, there are others: prolonged hyperglycemia, when the blood sugar level is higher than normal for a long time; high blood pressure; atherosclerosis; Smoking and alcohol consumption; liver and kidney diseases; pregnancy; obesity; genetic predisposition and some other factors. However, the two main reasons why diabetics have lesions of large and small vessels, and not only the eyes, but also the kidneys, heart, and lower extremities, are increased blood sugar and arterial hypertension. If these factors are kept under control, the risk of developing diabetic retinopathy is significantly reduced. It may not develop at all in diabetes with constant health monitoring — such cases also happen.

Diagnosis of diabetic retinopathy with the diagnosis of “diabetes mellitus”, you need to be examined by an ophthalmologist more often than healthy people — at least twice a year. As we said above, the first signs of retinopathy become noticeable in the last stages. Early diagnosis will help to identify changes in the fundus and treat the pathology in a timely manner. Here are the procedures performed by a specialist to examine the condition of the eye structures. A survey of the patient and the visual acuity testing — check of visual acuity using a table Sivtseva-Golovin. Tonometry-measurement of intraocular pressure (especially in patients with more than 10 years of disease experience). Ophthalmoscopy – examination of the fundus.

Badenoch
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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