Diabetic retinopathy refers to retinal changes that occur in patients with diabetes mellitus.
These changes affect the small blood vessels of the retina and can lead to vision loss.
The main types of diabetic retinopathy are non-proliferative(growth of microaneurysms ) and proliferative ( grow or produce by multiplication) diabetic retinopathy.
Vascular endothelial growth factor is screted by the ischemic retina. Increased vascular permeability resulting in retinal swelling/oedema and angiogenesis – New blood vessels formation.
Control of glucose and blood pressure.
Treatment of macular oedema is usually needed in order to prevent loss of vision to try to improve vision.
Treatment includes the use of lasers or injection of drugs that cause the retinal swelling/macular oedema to resolve.
Patient’s are seen monthly if being injected or every 3 months post-laser for macular oedema. Several studies indicate that indicate (VEGF)-Vascular endothelial growth factor, originally known as vascular premeability factor(VPF), is a signal protein produced by cells that stimulates the formation of blood vessels. Drugs are more effecctive than focal laser.
The laser is used to create scars on the peripheral retina. If successful, vitreous bleeding may be averted. Sometimes the proliferative disease is advanced and there is bleeding feeling the eye.
The goal of surgery is to remove blood and scar tissue from the retinal surface and to place laser treatment as needed.
There is always the low, but real, risk of infection of the eyeball(endopthamalitis).
It is important to know the hemoglobin A1C whether the patients blood pressure is under control.
Slit lamp examination and dilated fundus examination should be performed. You should look carefully for the presence of abnormal blood vessels, cataract( associated with diabetes ) and vitreous cells. Intraocular pressure should be checked especially when NVI ( Neurological vision impairment – cortical , blindness impairment ) is seen.
Dilated fundus examination should include a macular examination to look for microaneurysms, haemorrhage , hard exudates, cotton wool spots, retinal swelling (oedema).
Flurorescein angiography is used to determine the degree of ischaemia or the presence of retinal vascular abnormalities. Ocular coherence tomography(OCT) is useful to determine the retinal thickness measurements.
Haemoglobin A1C is a measure of the degree of glycemic control over the past 3 months.Generally, a HgbA1C</=7 is the goal.
So that systemic control of diabetics, hypertension, hyperlipidemia, hypercholesterolemia, nephropathy and other disease of paramount importance.
Stay Tuned !!