Diabetic Retinopathy (DR) is a typical microvascular complication of diabetes (DM). It is caused by specific morphological changes that result from metabolic disorders in Type 1 and Type 2 diabetics. It can also accompany other specific types of diabetes. In developed countries, it is along with its complications the most frequent cause of the onset of blindness in people aged 20 – 74 years.
Alongside chronic hyperglycemia, there are two other factors playing a role in developing Retinopathy: hypertension, and – by not yet explained mechanisms - dyslipidemia. As a result of hemodynamic, rheologic and structural changes in retinal microcirculation, capillar permeability is gradually increasing, leading to capillar obliteration and giving rise to areas of capillar nonperfusion that are in Type 1 DM are predominantly localized in the central peripheric parts of the retina, in Type 2 DM in the back part of the eyeball. Chronic renal hypoxia is the stimulus to a new formation of vessels in the retina and along the back area of the vitreous humour.
Diabetic Retinopathy can be divided into:
- Nonproliferative retinopathy (NPDR) (initial, mild, moderate and severe)
- Proliferative retinopathy (PDR) (initial and of high risk)
- Diabetic maculopathy (macular edema and clinically significant macular)
Treatment
- Risk factor intervention
- glycemia normalisation
- blood pressure
- Laser retinal coagulation
It is the only effective symptomatic treatment of DR. It significantly reduces the risk of loss of sharp vision. The optimally selected time of surgery plays a crutial role.
All diabetics should go at least once a year for regular eye ground check-ups, more frequently in the case of more severe Retinopathy.