DIABETIC RETINOPATHY AND ITS CAUSES

 

Diabetic retinopathy is a pathology of the retina caused by changes in permeability and vascular growth in patients with diabetes. Diabetic retinopathy is conventionally divided into non-proliferative, pre-proliferative and proliferative (actually according to the degree of growth of new blood vessels).

The classification is, in fact, even broader, and takes into account the presence or absence of microaneurysms, hemorrhages, hard and soft exudates, surrounded and ischemic areas. At the stage of proliferation, newly formed vessels, growth of fibrous tissue and retinal detachment provoked by them are detected . The USA Best Doctors provide the facilities in medical field.

In any case, hyperglycemia, ie an increase in blood sugar, has a detrimental effect on cells, including the vascular wall. It becomes less strong - blood and plasma go freely into the intercellular space, on the damaged endothelium easily form blood clots. Initially, diabetes affects small blood vessels, so retinal veins and arteries are no exception.

How does retinopathy affect the star?

In the initial stages of the decline of visual functions may not be. Of course, the retina - the thinnest nerve tissue - is very sensitive to interruptions in blood supply, but compensatory mechanisms, as well as a temporary well-being in the central, macular area, provide acceptable vision.

When blood leaks from the affected vessels - areas of the retina are found under hemorrhages or lose nutrition (partial thrombosis).

About that time the first symptoms of the disease will appear:

·         "Male" before the eyes;

·         image blur;

More dangerous signs - a sharp decrease in vision, the appearance of flashes (lightning), the instantaneous disappearance of a certain segment in the field of view (approaching the "veil"). Sometimes such phenomena indicate the development of retinal detachment

signs of retinopathy

The final diagnosis is established after a series of special instrumental studies. At our Center, the condition of the eye is diagnosed using:

Biomicroscopy (the anterior segment of the eye is also exposed to diabetes - patients develop cataracts faster, in the advanced stages of the iris sprout new blood vessels);

·         Tonometry (to exclude secondary glaucoma);

·         Ultrasonic biometrics (retinal fit control);

·         Perimeters (field of view estimates);

The last method is modern and innovative, it involves a step-by-step study of the retinal layers, accurately determines its integrity and thickness. It is performed, including for the control of treatment - comparing, for example, the amount of edema before and after treatment.

What to do with diabetic retinopathy?

Depending on the form and stage of the process determine the scope of treatment. The optimal path is determined by the doctor after diagnosis. The best doctors in USA provide the facilities in medical field.

One of the treatment options is a combination of anti-VEGF drugs with laser retinal coagulation . First, the drug is injected into the vitreous (intravitreal) inside the eye. It blocks endothelial vascular growth factor, causing new vessels to become desolate, the surrounding edema decreases.

This manipulation meets medical standards and is highlighted in current guidelines. The procedure is performed by a certified physician with experience in intravitreal injections. The injection is a mini-operation, so it is performed in a sterile operating room under local anesthesia. After the injection, I instill antibiotic drops to prevent bacterial infection.

Having thus reduced the risk of intraoperative hemorrhage, the ophthalmologist begins a crucial "round" of the fight against proliferation - the laser "burns" the functioning areas. You can learn more about the possibilities of laser action in the next section.

Running cases

If diabetic retinopathy is not detected or treated in time - the inevitable development of complications: retinal detachment, macular degeneration (changes in the central area of ​​the retina), massive hemorrhages in the vitreous or neovascular glaucoma. The latter occurs due to the fact that the outflow of intraocular fluid (the angle of the anterior chamber) is literally overgrown with newly formed vessels.

Treatment of complications is much more complicated and expensive than the primary disease. Moreover, the chance of a successful outcome is inversely proportional to the number of "aggravating factors".