Diabetic retinopathy is a major cause of blindness

  Diabetes is a major disease affecting human health, and the number of incidences continues to climb. According to the World Health Organization (WHO), about 150 million people were diagnosed with diabetes worldwide in 2000, and the number will increase to 300 million in 2025. In China, with the rapid development of the economy and the continuous improvement of people’s living standards, the population structure shows a clear trend of aging, and the incidence of diabetes is also significantly higher. The prevalence of diabetes in major cities such as Beijing and Shanghai has approached or exceeded the level of developed countries. At present, there are about 90 million diabetic patients in China, and there is a trend of ruralization and rejuvenation.  Diabetes affects various parts of the eye with various pathologies, such as easy exfoliation of corneal epithelium, cataract, diabetic optic neuropathy, diabetic retinopathy, and diabetic eye muscle paralysis. Among them, diabetic retinopathy (DR) is the most serious complication of diabetic eye disease and one of the important causes of blindness. The main manifestations of glucose retina are retinal ischemia and hypoxia (microangiomas, hemorrhages, cotton wool spots, intraretinal microvascular abnormalities, venous canal changes, neovascularization, proliferative membrane formation) and/or increased vascular permeability (exudation, hemorrhage), leading to vision loss and even blindness in patients.  In the United States, glucose reticulum is the leading cause of blindness in people of working age (20-70 years). According to a 2004 report in the United States, the prevalence of glycogen reticulum was about 40% among diabetics over 40 years of age (10.2 million people), with a prevalence of 8.2% for vision-threatening glycogen reticulopathy (VTDR). It has been reported that, if left untreated, 1/3 of patients with vision-threatening glucose reticulopathy will progress to legal blindness within 3 years. Even with aggressive early treatment, many diabetics eventually develop low vision or blindness. Globally, 3 to 4 million people lose their eyesight to this disease each year.  Data from the American Diabetes Association (2003) indicate that more than 2/3 of blindness in adolescents is due to diabetic retinopathy; in adults, 1/3 of legal blindness is due to glucose retinal disease. The risk of blindness is 10-25 times higher in diabetics than in normal subjects. At present, glycoplegia is also one of the major causes of blindness in China, and the overall number of blind people is considerable. The prevalence of blindness among diabetic patients was reported to be 1.1% and the prevalence of low vision was about 10% in 2006 by the Shanghai Eye Disease Control Center.  In contrast to the high prevalence and high blindness rate of glucose retinal disease, the awareness rate of the dangers of glucose retinal disease is relatively low. Many patients do not know they have diabetes, are unaware of the serious dangers of diabetes, or are unaware that early prevention and treatment of diabetic retinopathy can prevent vision loss. Health administrations and ophthalmologists have a long way to go in the fight against diabetic blindness. Borrowing from the Yellow Emperor’s Classic of Internal Medicine, “The upper doctor treats the untreated disease, the middle doctor treats the desired disease, and the lower doctor treats the existing disease”, the promotion and screening of diabetic retinopathy is far more important than the treatment.