Diabetic retinopathy
Disease information
Diabetic retinopathy
Diabetic
Retinopatía.
The proliferation and affectation of the blood vessels of the interior of the eye by the
diabetes
mellitus
produces the
diabetic
retinopatía.
Causes.
The
diabetes
is
a
general
disease
that
has
like more important complication the loss of vision.
The excess of sugar (glucose) in the blood causes important injuries in the blood vessels of all the organism.
These injuries are pronounced with special intensity at level of the
retina
, which causes the appearance of the denominated
diabetic
retinopatía.
Its appearance is in relation to the time of evolution of the
diabetes
and with the degree of control of the numbers of glucemia.
Whatever more years of whichever evolution and worse are the control, greater affectation of the
retina
.
Signs and symptoms.
The
diabetic
retinopatía is divided in two types:
Nonproliferativa the
diabetic
retinopatía, in which the vision diminishes by an alteration of the
central
zone of the denominated
retina
spot.
The loss of vision is relatively fast, and continuous.
It affects the first by day and fine vision.
Finally the vision is reduced to the resistances between light and shades, and to the forms of the things.
The proliferativa
diabetic
retinopatía, in which the vision diminishes by the appearance of hemorrhages and new blood vessels inside the vitreous cavity (later camera of the eye)
The loss of vision takes place by stages, according to is taken place the hemorrhages, noticing blurred zones in the field of view, that are extended in size and number.
It causes loosenings of
retina
very frequently.
Factors of risk.
Mellitus
diabetes
badly controlled.
Other factors that affect the blood vessels, like:
Tabaquismo.
Obesity
.
Hiperlipidemia (high
cholesterol
)
Arterial
hypertension
.
Prevention.
An
optimal
control of the
diabetes
is the best possible preventive measure, although it will not avoid the parición of this complication,
but
it will delay it and slow down its evolution to
a
great extent.
The other factors of risk will have also to be controlled already mentioned.
In order to prevent the diminution with the vision, it is necessary to make oftalmológicos controls to all the diagnosed patients of
diabetes
, although they refer to have
a
good
visual
sharpness.
The alterations of the vision, when they appear, already indicate an advanced state of the
disease
and in most of the cases, the medical performance can go directed to maintain the situation,
but
not to only improve it.
Diagnosis and treatment.
Ideally, the diagnosis will be made before
visual
deficiencies notice, by means of periodic ocular examinations.
In some patients,
a
normal
clinical exploration is not sufficient to value of correct form the injuries that present / display and is necessary to make an angiography with fluorescein to make
specific
them.
When the
diabetic
retinopatía is diagnosed of precocious form, effective methods exist to avoid the
visual
deterioration.
Treatment.
The treatment of the
diabetic
retinopatía is based in the first place on the strict control of the numbers of glucemia. In order to obtain this objective, it is fundamental the work of the attending physician and / or endocrinólogo, as well as the collaboration of the patient.
Nowadays, the most effective technique stops of the treatment of the
diabetic
retinopatía is the fotocoagulación with Argon laser.
The treatment with laser must be precocious possible and is able to stop the
development
of the retinopatía.
Diverse techniques of fotocoagulación exist and the ophtalmologist will seat the indication depending on the situation of
each
patient.
In many cases it is necessary to make several sessions of laser to complete the treatment.
Another possibility is the Vitrectomía, technical surgical in which the vitreous humor is replaced, gel that fills up the later part of the eye, by an artificial polymer) that is used for example when the vitreous hemorrhages are not reabsorven after
a
certain time.
Complications.
The incidence of blindness by
diabetic
retinopatía
has
in the last increased to years thanks to the greater life expectancy of the
diabetic
patients, being necessary therefore, to progress in the precocious diagnosis of the ocular complications of the
diabetes
.
The most frequent complications of the
diabetic
retinopatía are:
The vitreous hemorrhage:
bled within the eye.
one is
red
and stumped.
it can leave spots permanent that make difficult the vision.
The loosening of
retina
:
The layer that at heart catches the light of the eye breaks, taking off
itself
: blurred and changing vision.
if it is not solved quickly, the receivers of the light the generous zone dies, having left blind person.
if the spot is affected (zone of the
finest
vision) the loss of Vista is very important.
Prognosis.
Detected on time he is controlable, although nonrecoverable.
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