Related articles: Diabetic retinopathy
Definition
Diabetic retinopathy is a complication of diabetes.
At the base of this ocular pathology there is an alteration of the microvascular system, which involves damage to the walls of the small blood vessels present in the back of the eye. This process causes an increase in capillary permeability and the subsequent accumulation of fluids in the retinal tissue (diabetic microangiopathy). When diabetic retinopathy becomes more severe, new blood vessels start to form on the retinal surface, which can break, damage the retina and cause a sudden and painless reduction in visual acuity. The degree of the disease is strongly correlated with the duration of diabetes, blood glucose levels and blood pressure.
Most common symptoms and signs *
- Eye fatigue
- Halo around the light
- Altered color vision
- Night Blindness
- Movable bodies
- photopsias
- Narrowing of the visual field
- Reduced vision
- Intraocular bleeding
- scotomas
- Double vision
- Blurred vision
Further indications
In the early stages, diabetic retinopathy may not cause any symptoms. However, disease progression can result in loss of visual function, which, in many cases, cannot be reversed. Diabetic retinopathy usually affects both eyes and is characterized by neovascularization, increased capillary permeability and microaneurysms (small extroflexions of the wall of the capillaries of the retina that often cause the pouring of fluids). Characteristic features of the disease are also exudates (lipid deposits on the retina), bleeding and tractional retinal detachment. The visual symptoms are associated above all with macular edema or macular ischemia (the small blood vessels that supply the retina can become blocked): in both cases the macula no longer receives a sufficient blood supply to function properly, causing obfuscation of vision.
Macular edema, that is the thickening of the central part of the retina, caused by the leakage of liquids from the capillaries, is the most frequent cause of blindness from diabetic retinopathy. Symptoms may also include the reduction of night vision, the difficulty in perceiving colors, the appearance of moving bodies (floaters), bright flashes (photopsies) or empty and dark areas in the visual field.
The characteristic signs of diabetic retinopathy may be visible upon examination of the fundus; further details are highlighted with fluorescein angiography and optical coherence tomography (OCT). In addition to careful management of diabetes, the treatment uses laser photocoagulation, intravitreal injection of drugs, vitrectomy or a combination of these methods.
Since the symptoms of diabetic retinopathy occur, the condition can be very difficult to control. For this reason, patients with diabetes are recommended to undergo a thorough eye examination at least once a year.
