Diabetic retinopathy is one of the eye complications in diabetic patients and is the most common cause of blindness in diabetic patients. Wang Hongge, Ophthalmology Department, Workshop
I. Clinical presentation and staging
Most diabetic patients begin to affect the fundus of the eye at about ten years into the course of the disease. Diabetic retinopathy is divided into 6 stages according to the severity of the disease. The first 3 stages, also called simple diabetic retinopathy, are the early stages of the disease. In this stage, fundus examination will reveal retinal microangiomas, small hemorrhages and exudates. In this stage, vision is unaffected, but in some cases, vision is reduced to varying degrees due to macular edema.
The latter 3 stages are proliferative diabetic retinopathy, the main changes are neovascularization and fiber proliferation on the retina, and retinal detachment occurs in the most severe cases.
II. Treatment
Early stage lesions usually do not require special treatment, but close ophthalmic follow-up should be carried out to keep abreast of changes in ocular conditions and actively control blood glucose levels to prevent further development of ocular lesions. If hemorrhage and neovascularization appear in the fundus, then fundus fluorescence angiography should be performed in a timely manner to check for areas of nonperfusion, and if the extent is 5 optic disc sizes, then retinal photocoagulation should be performed in a timely manner to prevent further development of the lesion.
For patients with more severe proliferative diabetic retinopathy, such as repeated massive hemorrhage in the fundus, large fibrous proliferative membrane or retinal detachment, vitrectomy should be performed as soon as possible to avoid irreversible visual impairment.
III. Prevention
Most of the damage of diabetic retinopathy on visual function is irreversible, so prevention of the disease is especially important, among which reasonable control of blood sugar is the key to prevent diabetic retinopathy. It is especially important to prevent the liver and kidney function from being affected. When the liver and kidney function is abnormal, the recovery of the disease is not good even with surgery. Secondly, regular eye examinations every year to detect abnormalities and deal with them in time!