Dra. Daniela Barba Castelo | Ophthalmologist
Diabetic retinopathy
Dra. Daniela Barba Castelo | Ophthalmologist
What is diabetic retinopathy?
Diabetic retinopathy is the affectation of the retina caused by the lack of control of Diabetes Mellitus (DM). Patients with type 1 DM have a more than 90% risk of presenting retinopathy, whereas patients with type 2 DM have a 60% risk of presenting retinopathy over 20 years with the disease.
Risk factor's
The first risk factor for presenting diabetic retinopathy is suffering from a lack of glucose control for a long time; likewise, progression also depends on glucose levels.
This occurs due to microangiopathy, that is to say that the arteries and veins of the retina present phenomena of obstruction and increased permeability. As there is obstruction in the small arteries, there is a lack of blood supply to the retina causing ischemia, this increases the permeability of the blood vessels causing the accumulation of fluid in the retina.
One of the main symptoms is loss of vision, which tends to be gradual but once the disease is advanced, vision can be severely affected.
Diagnosis
Every patient who is diagnosed with diabetes mellitus, an annual ophthalmological check-up is important in order to classify diabetic retinopathy if it is present.
There are different studies that help us assess the state of the retina:
Fluorescein angiography that helps assess the condition of the blood vessels.
Optical Coherence Tomography (OCT) of the macula that gives us information on the state of the layers of the retina, this test is commonly performed when macular edema is suspected.
Complications
Among the most common complications are:
Vitreous hemorrhage
Tractional retinal detachment
Neovascular glaucoma
The treatment will be evaluated in each case.Diabetic macular edema is caused by the increased permeability of the blood vessels, which causes the accumulation of fluid in the area of better vision, causing a decrease in vision and sometimes it can be noticed with distortion of the images.
Treatment
It is important to know that to avoid the progression of the disease it is important to manage a good metabolic control.
When the retina shows signs of significant ischemia, it causes changes in the blood vessels, so in these cases photocoagulation sessions may be necessary in order to stop the progression of the disease.
When macular edema occurs, antiangiogenic drugs are applied in order to reduce the permeability of the vessels; In selected cases, corticosteroids can be used within the eye. Unresolved complications of diabetic retinopathy can be treated with surgery.
