I. What is diabetic retinopathy
Diabetic retinopathy is one of the common and serious complications for diabetic patients, and is a serious blinding eye disease.
After a certain number of years of diabetes, diabetic patients can cause lesions in multiple parts of the eye, such as
1. Cataracts caused by diabetes
2.Diabetes-induced optic nerve damage
3.Diabetes causes myopia or hyperopia
4.Diabetic retinopathy
Second, who are vulnerable to diabetic retinopathy
China’s economy has developed rapidly in recent years, and the number of patients with diabetic retinopathy has increased. However, not all diabetic patients have diabetic retinopathy. Diabetic patients are prone to diabetic retinopathy in the following cases
1. There is a long history of diabetes.
The duration of diabetes is the most important risk factor for the development of diabetic retinopathy.
2. Poor glycemic control
It is generally accepted that the duration of diabetes and the severity of blood glucose abnormalities are the most important risk factors for the occurrence of diabetic retinopathy.
3.Other aspects
Older people are prone to difficult-to-control diabetic retinopathy. Type 1 diabetes is more prone to diabetic retinopathy than type 2 diabetes. Kidney disease and cardiovascular system disease are more prone to diabetic retinopathy.
Third, how diabetic retinopathy occurs
Simply put, the elevation of blood glucose causes changes in the blood vessels of the retina, resulting in insufficient blood supply to the retina.
IV. Clinical diabetic retinopathy staging
The commonly used clinical staging of diabetic retinopathy was proposed by our fundoplication group in 1985, and is divided into simple and proliferative types, with six stages.
1. The simple type has three stages.
Stage I Microaneurysm or with small hemorrhages
Phase II: Yellowish-white hard exudate or hemorrhagic spots
Stage III: White soft exudate or bleeding spot
2.Proliferative type has three stages.
Stage IV with neovascularization or vitreous hemorrhage in the fundus
Stage V Neovascularization and fiber proliferation in the fundus
Stage VI: Neovascularization and fibrous proliferation in the fundus, with retinal detachment
Five, diabetic retinopathy performance and harm
1. In the early stage, the patient does not feel anything, but the doctor can already see the changes in the fundus of the eye through examination;
2.When retinal edema appears, patients can have blurred vision;
3.If the vitreous hemorrhage is more, it will obviously affect the vision, and even completely lose sight of things;
4.When the retinal edema affects the macula, the patient can feel the distortion of vision;
5, late severe hemorrhage retinal detachment, often blind;
6. If neovascularization of the iris or atrial angle occurs, neovascular glaucoma symptoms may appear, and there may be uncontrollable eye pain, headache, nausea and vomiting, etc.
Six, diabetic retinopathy should do which examination
1, diabetic patients should see an ophthalmologist regularly and undergo examination and treatment according to medical advice.
2, if there is no diabetic retinopathy performance, can be a year or follow the doctor’s instructions to re-examine.
3.If microangiomas, hemorrhages, hard exudates, soft exudates and retinal edema of the retina appear, fundus fluorescence angiography or regular re-examination can be done according to medical advice.
Seven, systemic disease control on diabetic retinopathy is helpful
1.Glucose control;
2.Blood pressure control;
3, control of hyperlipidemia; can reduce the microvascular lesions and microvascular lesions caused by the
Complications.
VIII. What are the medications for diabetic retinopathy?
1, drugs to improve retinal microcirculation; 2, antioxidants; 3, anti-inflammatory agents; 4, anti-vascular endothelial growth factor drugs, etc.
9.What is the principle of laser treatment for diabetic retinopathy?
For patients who start to show proliferative changes, retinal laser photocoagulation is an important treatment method.
Laser treatment is an important tool to reduce retinal neovascularization, prevent macular edema exudation and retinal vitreous hemorrhage, and thus reduce visual function impairment. Laser treatment generally has a stabilizing effect on vision and does not directly improve visual acuity.
More severe cases of diabetic retinopathy require total retinal photocoagulation, which is usually done in 3-4 sessions, each 7-10 days apart. After laser photocoagulation, regular follow-up is required and supplemental photocoagulation is performed as necessary based on fundus fluorescence imaging tips.
X. Why some patients’ vision decreases after laser treatment
Laser treatment generally plays a role in stabilizing vision, but due to the temporary increase in retinal edema after laser treatment, it may lead to a decrease in central vision in the early post-treatment period.
1. The fundus lesion has reached the period of easy vitreous hemorrhage, and the vitreous hemorrhage happens to occur just after laser treatment, and the patient’s vision will be significantly reduced. This is coincidental, even without laser treatment, vitreous hemorrhage may occur.
2. The patient has a previous history of vitreous hemorrhage, and the vitreous in front of the retina forms a mold-like clouding.
Eleven, can diabetic retinopathy be treated surgically
In advanced diabetic retinopathy, vitrectomy is a remedial means to save the patient’s limited vision.
The purpose of vitreous surgery is to remove the cloudy vitreous, separate and cut the mechanized and proliferative membranes from the retinal surface, release the retinal traction, restore the normal retinal anatomy and clarify the refractive media. Patients who need surgery include.
1.Vitreous blood accumulation that cannot be easily absorbed;
2, combined retinal detachment and retinal fissure;
3, optic disc or peripheral retinal traction;
4, macular traction;
5.Dense pre-macular hemorrhage;
6.Progressive fibrovascular proliferation;
7, clinically persistent macular edema or lipid exudation, etc.
12.How to prevent diabetic retinopathy
1.Regular fundus examination If the fundus is normal, the pupil should be dilated once a year in the future.
2.Early treatment If you have eye complications, follow the doctor’s instructions, take medication on time and do the necessary tests, such as fundus angiography.
3.Control blood sugar, blood pressure, blood lipids, and actively treat diabetes; delay the appearance of diabetic retinopathy as much as possible.