Diabetic retinopathy

Diabetic retinopathy

Description of diabetic retinopathy

Retinopathy is the designation for the pathological changes of the retina and its vessels, which arise in the context of overall disease. Such overall diseases include diabetes (diabetes mellitus, abbreviated as DM), high blood pressure (hypertension), increased blood lipids (hyperlipidemia), vascular inflammation (vasculitis). Furthermore, damage to blood vessels can occur as a complication of pregnancy (nowadays already but relatively rarely) in premature babies (especially born before the 8th month of pregnancy) and blood diseases (such as leukemia or plasmacytoma).

If this is “only” about disability retinal vessels, we are talking about so-called vasculopathy(vasculogenesis = vascular, peripheral neuropathy = pathological process). In the event that on the basis of violations on vascular function to breach the retina, then we speak of retinopathy.

It’s good to know that the retina is the only place in the body where the doctor has the ability to directly observe the blood vessels, thus examination of the eye (see below) is not only good for the ophthalmologist, but also for doctors in other fields – such as internists, neurologists, from Therefore, the changes that are visible on the retina, are foreseeable in other parts of the body (brain, heart, kidney etc.).

Diabetic retinopathy is the most common retinal vascular disease. It is one of the most advanced organ complications of diabetes. Its incidence is on average after ten years of illness – but this figure is very individual. If a person with diabetes treated well (compensated) coming later complication of this type, on the other hand, some individuals may retinopathy occur much earlier.

Diabetic retinopathy is a serious health – social problem, because despite the sophistication of treatment and treatment options for diabetes, this disease is the leading cause of blindness in industrialized countries. On average approximately 2% of diabetics due to diabetic retinopathy become blind. A rise in diabetes, unfortunately, is still growing.

Of course, it is blindness to the latest version, but usually in diabetic retinopathy reduces visual acuity – some patients may not be significant, significant other is a lot and significantly reduces quality of life.

In the event that the blindness due to retinopathy, it is necessary to assume the overall severe disability other vessels in the body and such a situation is indeed very serious.

The changes are often visible to the naked eye on other parts of the body and before the onset of retinal changes – it is meant, for example, so-called diabetic foot (disability toes, feet and lower leg. This happens due to poor blood supply to the terminal portions body).

The basis of diabetic retinopathy is damage to blood vessels in the retina. How do you imagine?The vessel operates as a supplier and the customer. Tissues and through vessels receive oxygen and nutrients and the other side to the vessel surrender waste metabolic products, which a given tissue is produced and which, if accumulated, could act tissue toxicity. It’s a pipe that is so intelligent that he can discern what is allowed where lay out where and what is let in and take away.

To ensure that everything worked so idyllic, it is necessary to the proper function of the vascular wall. And it is already damaged by diabetes. Damaging should be seen as a long-term process, nothing will happen from day to day, let alone serious complications.

As this damage actually work? Vascular wall is made up of cells, called the endothelium.Endothelium just decide on the two-way passing through the vessel. If it is damaged in diabetes leads to the fact that the vessel will increase its permeability outwards. And this leads to swelling(edema =) retina.

Filtered mainly water and protein substances. Further they can pass and high molecular substances, such as fats – they begin to accumulate in the retina, and since there is not a sufficient mechanism for their removal and formed islets are hardened mass.

The next level of damage is complete occlusion of the capillary bed. If the tissue has no oxygen, it becomes a so-called hypoxic is no supply, without the supply of oxygen, nutrients and outflow of waste products. For these cases, the retina is equipped with the ability to produce the factor which causes the formation of new capillaries. Unfortunately, it becomes problematic, begin to form new capillaries in order to maintain circulation is still intact, but these capillaries form in the wrong places. For example, the front of the retina and vitreous. Thus, it completely eliminates their ability to nourish tissue because the Food tissue capillaries must be a part of it and in this case it is not so.

Additionally, these capillaries are very fragile, so they often crack and are the source of bleeding.If bleeding occurs in the tissue and the blood that flows into the tissue, it changes over time, so to speak, and organizes it in the last stage into the connective tissue. The resulting tissue can causeretinal detachment and mechanically – resulting fibrous strip retina pulls from the ground.

Factor that causes the formation and growth of new blood vessels could circulation of intraocular fluid getting into the front part of the eye, where there is a pathological formation of new blood vessels. These vessels, because they grow in the area where the vernacular have nothing to do clog the places where the intraocular fluid flows and this mechanism will contribute to the risk ofglaucoma or glaucoma.

Diabetic retinopathy is divided into either proliferative (proliferation = growth), which involves the formation of new, pathological capillaries and so-called non-proliferative, when the capillaries have formed. Proliferative form of diabetic directly threatens the loss of vision.


Risk factors for diabetic retinopathy

Here is the only possible risk of diabetes, either the first or second type (see more problems of diabetes). Moreover, if not properly compensated diabetic or undisciplined and does not follow your doctor’s advice, the risk is much greater retinopathy.


Prevention of diabetic retinopathy

Effective prevention is practically non-existent. If a person is born with diabetes can do for yourself only that it will comply with all medical recommendations. Prevent diabetes of the second type is possible and it’s overall design lifestyle – but again, I am referring to the issue that is discussed in detail in another article.

In case the disease is already present, it can be recommended only correct lifestyle and effort to relieve maximum body, which is weakened by the disease, retinopathy so formed as late as possible, or preferably not at all.


Signs and symptoms of diabetic retinopathy

Deterioration of visual functions in the sense of decreased visual acuity, which deteriorates over time. In severe cases, blindness – but that is more a consequence than a first symptom.

Definitely not worth the deteriorating sight function to ignore or to consider it “something normal due to age.” Indeed it is not so early and visit an ophthalmologist can save not only the eyes but also to prolong life, because as has already been mentioned, the retinopathy is just another link in the series of total disability vessels throughout the body.


Treatment of diabetic retinopathy

Previously, the treatment of diabetic retinopathy zero and the doctor just checked the condition of the patient and save his eyesight could not do nothing. The late seventies appeared the first lasers that this issue fundamentally shifted forward.

Laser therapy works by photocoagulation. What does that present? Fotos is light and coagulation clotting of blood, so the meaning of the words. How it works is that a thin laser beam (specifically greenish light) intervene on the periphery of the retina. Center is always omitted (instead of sharpest vision, distance optic nerve and blood supply input – if these structures were damaged, he would be permanently destroyed sight).

Laser formed in blood vessels to blood clots (clot) to subsequently destroy the entire vessel. This will eliminate the neprokrveného district, poor in oxygen. By such a district destroyed, ceases to produce a factor that leads to the formation of new blood vessels. New blood vessels gradually disappears, ideally completely.

But the success of therapy depends on the stage. If retinopathy captured still at a stage where capillaries proliferate, there is hope for success is relatively large and diabetic nor threatened by an acute threat to vision loss. At the same time the laser light is able to enter leaky capillaries – thereby reducing the swelling of the retina.


How do I help myself

In this case, the man himself can help only by strictly adhere mode, which is recommended for diabetics, will increasingly take care of their health and will pay attention to any changes that the organism starts to develop. Only in this way you can achieve success retinopathy therapy, performed by an ophthalmologist. Early detection is really the most important thing!


Complications of diabetic retinopathy

Complications of the disease are few. It is necessary at this disease seen as a system, such that if it is, it is necessary to assume the overall impairment of the organism, mainly the blood vessels.

Statistics show that diabetics who are blind due to diabetic retinopathy, survive on average more than five years. Disability organism is already so serious and vascular function is so damaged that it is not compatible with long-term survival.

First and foremost is a complication of reduced visual acuity and blindness – as discussed above, diabetic retinopathy is the leading cause of blindness in developed countries.

Other complications include vitreous hemorrhage, retinal detachment.

Other Names: retinal disease in diabetes, retinal microangiopathy, impaired retinal vessels and the retina due to diabetes mellitus, the retinal microangiopathy

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