Diabetic retinopathy (DR) is the most important manifestation of diabetic microangiopathy, which is a kind of fundus lesion with specific changes and is one of the serious complications of diabetes mellitus. Diabetic retinopathy without retinal neovascularization is called nonproliferative diabetic retinopathy (NPDR) (or simple or background type), while diabetic retinopathy with retinal neovascularization is called proliferative diabetic retinopathy (PDR). retinopathy (PDR). Clinical manifestations 1, vision loss; 2, fundus manifestations: retinal microangioma and punctate hemorrhage mainly in the posterior pole; retinal hemorrhagic spots; hard exudative spots; cotton wool-like white spots; retinal artery thin and narrow resembling hypertensive atherosclerosis manifestations; retinal vein dilatation, early homogeneity, late bead-like or globular dilatation; vascular occlusion and neovascularization; proliferative retinopathy. 3. Fundus fluorescence angiography: there are various manifestations. Mainly visible are vascular abnormalities and leakage, ischemic non-perfused areas and hemorrhagic obscured fluorescence. Medication Treatment Chinese medicine treatment methods Treatment should be combined with diabetes mellitus, and the trinity of dietary management, blood sugar control and identification and treatment of this disease must be integrated. Western medicine treatment methods (a) Treatment 1, drug treatment (1) long-term control of diabetes: the fundamental treatment of diabetic retinopathy is the treatment of diabetes. In principle, blood sugar should be controlled to normal or near normal level first and often. (2) Reduce blood lipids: (3) control blood pressure: elevated blood pressure can aggravate diabetic retinopathy, when hypertension is controlled, fluorescence leakage is significantly reduced, so blood pressure should be controlled in patients with diabetes combined with hypertension. (4) doxium: It is said that doxium (calcium 2,5-dihydroxybenzenesulfonate) has significant inhibitory and reversal effects on the “three high” factors that cause diabetic retinopathy, namely high capillary permeability, high blood viscosity and high platelet activity. Early and long-term administration may be beneficial for the prevention and treatment of diabetic retinopathy, but the exact clinical effects need to be further verified. Commonly used dose 500-1500mg/d, divided into 1-3 doses. (5) Aspirin: It can inhibit the production of thromboxane and prostaglandin metabolites, inhibit platelet agglutination, and have a certain preventive effect on microthrombosis. Commonly used 300mg/time, 1 time/d, orally, to prevent the occurrence of retinopathy. However, aspirin has been reported not to slow down the progression of retinopathy in clinical practice. Other agents such as aldose reductase inhibitors, calcium channel blockers, growth hormone release inhibitors, and antihistamines may have positive effects on the prevention and treatment of diabetic retinopathy, and further studies are needed. In conclusion, although treatment is difficult, control of blood glucose levels from the onset of diabetes is most important to prevent diabetic retinopathy. 2. Photocoagulation Laser therapy is considered to be an effective treatment for diabetic retinopathy. For proliferative diabetic retinopathy, once neovascularization appears in the fundus, even if it is only in the size of 1PD range, whole retinal photocoagulation should be done. 3.Condensation therapy Condensation is mainly used for patients who are not suitable for photocoagulation therapy or as a complementary therapy to photocoagulation therapy, such as patients with refractive interstitial opacities or retinal peripheral lesions that cannot be treated by photocoagulation. The method is circumferential condensation of the conjunctival or scleral surface between the serrated edge and the vascular arch. 4, vitrectomy For diabetic retinopathy, the basic indications for vitrectomy are vitreous hemorrhage and severe proliferative lesions. It is generally believed that vitrectomy is required for those with extensive vitreous hemorrhage that cannot be spontaneously absorbed for more than 3 months. However, clinical practice has proven that postponement of surgery is detrimental, and early implementation of vitrectomy for new severe vitreous hemorrhage is much more likely to restore good vision than postponement of surgery. The reason may be to prevent distortion or detachment of the retina, especially the macula, due to hemorrhage mechanization, adhesions, and traction. If neovascularization and fibrous proliferation have been found to be more extensive before the vitreous hemorrhage, vitrectomy should be performed even earlier. The best time to perform the surgery is half to one month after the hemorrhage. For retinal detachment without vitreous hemorrhage but with severe proliferative lesions or involving the macula, vitrectomy is also feasible. The purpose is to release the involvement, destroy the neovascularization by intraocular electrocoagulation or photocoagulation, and reset the detached retina by intraocular injection of filler. Principles of disease treatment Principles of treatment 1.Treatment of diabetes, control of blood sugar. 2.Argon laser, photocoagulation therapy. 3.Surgical treatment: vitreous cut if vitreous hemorrhage cannot be absorbed. For retinal detachment, vitrectomy plus annuloplasty is performed. 4.Medication: Chinese herbal medicine to activate blood circulation and improve microcirculation. Medication principle 1.Treatment of diabetes mellitus (endocrinology is responsible). 2.The ophthalmology specialist will carry out laser photocoagulation treatment according to the fundus lesion in stages. 3.Proliferative lesions and severe vitreous hemorrhage that cannot be absorbed are treated with vitrectomy. 4.Activate blood circulation and reduce blood vessel permeability drugs to promote the absorption of accumulated blood. Dietary care Desirable food The diet should include a high proportion of carbohydrates and fiber, adequate amount of vitamins and minerals, and a small amount of protein and fat. It is best to eat more coix seeds, bran, pumpkin and adzuki beans as the main food, and more vegetables containing less carbohydrates such as celery, cabbage, leek, cabbage, spinach, winter melon and tomatoes as the side dishes. Food containing more protein, such as soybeans, eggs, lean meat, etc. is also more appropriate. According to research, onions, eels, turtle, etc. can help the body’s cells to better use glucose, has a hypoglycemic effect, so can often eat. Avoid eating fatty, sweet, thick, spicy and hot products, such as garlic, chili, ginger, pepper, fried food, to prevent dry heat and fire injury, fatty and sweet to help moisture and heat. Should also avoid sweet things, such as white sugar, brown sugar, rock sugar and sweet snacks, sweet drinks and all sugary products, fruits, potatoes and other things should also control their dosage. Drinking water may not be too restricted. Prognosis The prognosis is good with early diagnosis and treatment. The prognosis is poor once comorbidities occur such as hemorrhagic glaucoma, vitreous hemorrhage, macular degeneration and retinal detachment.