Patients who have had
diabetes for a long time are at high
risk of developing diabetic retinopathy,
the disease remains a frequent cause of
blindness among adults. It is estimated
that diabetes patients are 25 times more
likely than non-diabetic blindness.
Diabetic retinopathy is an ocular
complication of diabetes caused by
damage to blood vessels that irrigate
the retina (fundus oculi). These
weakened blood vessels can be let out
fluid or blood, to form branches in the
form of brittle brush, and enlarged in
certain places.
When blood or fluid coming out of
injured vessels or fibrous tissue forms
in the retina, the image sent to the
brain becomes blurred.
There are two types of diabetic
retinopathy:
The non-proliferative, which is the
initial stage of diabetic retinopathy.
In some patients, the exudative fluid is
deposited in the macula. This is the
central portion of the retina, which
allows the central vision. The images of
objects directly in front of us, reading
and detailed work can become blurred and
the loss of central vision can become a
legal blindness. Non-proliferative
retinopathy is a danger signal, it can
advance to more severe stages and damage
vision.
The proliferative, which begins in the
same way that non-proliferative, but
also there are neo-formation of blood
vessels on the surface of the retina or
optic nerve. These new blood vessels,
which are very fragile, they can tear
and bleed into the vitreous humor, the
transparent gelatinous substance that
fills the center of the eyeball. If the
blood becomes opaque vitreous humor that
is usually transparent, it blocks the
light passing into the retina and the
images are distorted. In addition, the
fibrous tissue that forms from the mass
of broken blood vessels in the vitreous
can shrink and pull the retina off the
back of the eye. Blood vessels can also
form in the iris and cause increased
pressure in the eye, causing severe loss
of vision.
What are the treatments?
There are various treatments, the most
significant is to use a laser to close
or fotocoagular leaky blood vessels.
This treatment requires no incision. If
diabetic retinopathy is detected early,
laser photocoagulation can stop the
damage.
|
Before |
After |
|
Photos of the eye of a patient with Non-Proliferative
Diabetic Retinopathy. |
Photo taken after the application of laser
treatment. |
|
|
Image of sodium fluorescein angiography study of
the eye, where you can see the traces (black dots), the
application of the laser. |
In cases where the
vitreous is full of blood is necessary
to perform a vitrectomy, the vitreous
was filled with blood drawn from the eye
and replaces it with an artificial
solution transparent.
|
Before |
After |
|
Photos of the eye of a patient with proliferative diabetic
retinopathy
|
Photo taken after the vitrectomy via pars plana
|
Recently this was
injected into the eye antiangiogenic
substances that promote the reduction of
edema and closure of the neo-formed
vessels, which are responsible for
bleeding.
|
Before |
After |
|
 |
 |
|
Photos of the eye of a patient with proliferative
diabetic retinopathy with vitreous hemorrhage |
Photo taken after treatment with injection of
anti |
|
Before |
After |
|
Photos of the eye of a patient with proliferative
diabetic retinopathy
Image study sodium fluorescein angiography, which shows the
exhaust from neovases (large white patch on the left side)
|
It notes the closure of neovases after the
application of intravitreal injections of antiangiogenic.
|
The important to remember
that successful treatment of diabetic
retinopathy depends not only on the
early discovery and treatment given by
the ophthalmologist, but it goes hand in
hand with personal care of the patient,
who must take all medications and comply
with diet recommended for controlling
diabetes.
