Shukla Unnati V., Tripathy Koushik
Centre for Sight new delhi
ASG Eye Hospital, BT Road, Kolkata, India
Diabetic retinopathy (DR) is a microvascular disorder occurring due to the long-term effects of diabetes mellitus. Diabetic retinopathy may lead to vision-threatening damage to the retina, eventually leading to blindness. It is the most common cause of severe vision loss in adults of working age groups in the western world. Early detection and timely intervention are the keys to avoiding blindness due to diabetic retinopathy. The number of patients with diabetic retinopathy in America is estimated to reach 16.0 million by 2050, with vision-threatening complications affecting around 3.4 million of them. The usefulness of strict glycemic control was clearly seen in clinical trials like the UK Prospective Diabetes Study (UKPDS) and Diabetes Control and Complication Trial (DCCT). Uncontrolled diabetes can lead to many ocular disorders like cataracts, glaucoma, ocular surface disorders, recurrent stye, non-arteritic anterior ischemic optic neuropathy, diabetic papillopathy, and diabetic retinopathy. Diabetic retinopathy may lead to vision-threatening damage to the retina, eventually leading to blindness; it is the most common and severe ocular complication. Poor glycemic control, uncontrolled hypertension, dyslipidemia, nephropathy, male sex, and obesity are associated with worsening diabetic retinopathy. Typical fundus features of diabetic retinopathy include microaneurysms, hard exudates, macular edema (diabetic macular edema or DME), and new vessels (in proliferative DR or PDR). The management options include strict control of the systemic conditions, intravitreal pharmacotherapy, and laser photocoagulation. With early diagnosis and prompt management, good final visual acuity may be achieved in most patients with DR.
糖尿病性视网膜病变(DR)是一种由于糖尿病长期影响而发生的微血管疾病。糖尿病性视网膜病变可能导致对视网膜的视力威胁性损害,最终导致失明。它是西方世界工作年龄组成年人严重视力丧失的最常见原因。早期检测和及时干预是避免因糖尿病性视网膜病变导致失明的关键。据估计,到2050年,美国糖尿病性视网膜病变患者数量将达到1600万,其中约340万人会出现视力威胁性并发症。在英国前瞻性糖尿病研究(UKPDS)和糖尿病控制与并发症试验(DCCT)等临床试验中,严格血糖控制的有效性清晰可见。未控制的糖尿病会导致许多眼部疾病,如白内障、青光眼、眼表疾病、睑腺炎反复发作、非动脉炎性前部缺血性视神经病变、糖尿病性视乳头病变和糖尿病性视网膜病变。糖尿病性视网膜病变可能导致对视网膜的视力威胁性损害,最终导致失明;它是最常见且最严重的眼部并发症。血糖控制不佳、高血压未控制、血脂异常、肾病、男性以及肥胖与糖尿病性视网膜病变恶化有关。糖尿病性视网膜病变的典型眼底特征包括微动脉瘤、硬性渗出、黄斑水肿(糖尿病性黄斑水肿或DME)以及新生血管(增殖性糖尿病性视网膜病变或PDR)。治疗选择包括严格控制全身状况、玻璃体内药物治疗和激光光凝治疗。通过早期诊断和及时治疗,大多数糖尿病性视网膜病变患者可能获得良好的最终视力。