Sunday 13 December 2009, 23:12

Diabetic retinopathy

What diabetic retinopathy is and how it can be prevented

Diabetic retinopathy

Retinopathy is a common long-term complication of type 1 diabetes, affecting patients after several years of untreated or poorly managed diabetes. Its onset (usually at puberty) is often subtle and a late diagnosis may lead to severe complications, even blindness. Therefore it is important to have any eye or vision problems diagnosed as early as possible.


Diabetic retinopathy is a progressive retina disease, caused by a damage in the small retinal blood vessels. It develops with a sequence of stages eventually leading to vision loss. At the earliest stage, microaneurisms occur (retinal arteriolar dilatation). With the progression of the disease, a greater and greater number of retinal vessels are blocked, depriving several areas of the retina with their blood supply. To compensate, new thin fragile vessels start growing along the surface of the retina and the vitreous humor (proliferative retinopathy). By themselves these new vessels don't compromise vision, but if they start bleeding vision may be suddenly lost.


Since symptoms are often absent in the early stages of the disease, diabetic patients require routine eye examinations (at least once a year) in order to detect and treat any eye problem as early as possible. The diagnosis of retinopathy may be done through a detailed examination of the retina with an ophthalmoscope.


The pathogenesis of diabetic retinopathy has been extensively investigated. The most important pathogenetic factors are hypertension and persistent hyperglycaemia. Therefore the most effective means to prevent the progression of retinopathy in diabetic patients are tight control of blood pressure and blood glucose.


These measures are effective only in the first stages of the disease. If the disease progresses to the proliferative stage, the only treatments available are laser surgery (to shrink the abnormal vessels) and, when vitreous haemorrhage occurs, vitrectomy (to remove blood and vitreous from the eye and replace it with saline). 


By Chiara De Carli

Category: Diabetes

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