Presentation
The present article describes two diabetic patients and discusses the management of patients with severe proliferative retinopathy or diabetic maculopathy. [ncbi.nlm.nih.gov]
Eyes
- Retinal Hemorrhage
The retinopathy in association with malaria fever described so far includes retinal hemorrhages, vessel changes, retinal discoloration/whitening and papilledema. [ncbi.nlm.nih.gov]
These blood vessels are fragile and can cause large hemorrhages in the eye (vitreous hemorrhage). Scar tissue can form on the surface of the retina, leading to retinal detachment. [vrssurgery.com]
Any NVD with vitreous hemorrhage 3. NVE ≥ ½ disc area with vitreous hemorrhage High-risk PDR was also defined as three or more of the following high-risk characteristics (HRC’s): 1. Presence of vitreous hemorrhage or pre-retinal hemorrhage 2. [bu.edu]
These symptoms are typically caused by vitreous hemorrhage or traction retinal detachment. [merckmanuals.com]
- Retinal Microaneurysm
Klein R, Meuer SM, Moss SE, Klein BE (1989) The relationship of retinal microaneurysm counts to the 4 year progression of diabetic retinopathy. Arch Ophthalmol 107:1780–1785 PubMed CrossRef Google Scholar 24. [link.springer.com]
[…] that in women with mild background diabetic retinopathy the number of retinal microaneurysms increased progressively during pregnancy but underwent substantial regression postpartum though not quite returning to preconception levels. 10 On the other [bjo.bmj.com]
This classification is characterized by the presence of at least one retinal microaneurysm or hemorrhage. Microaneurysms are outpouchings of retinal capillary walls, caused by loss of pericytes of the cell wall—which leads to weakening. [reviewofoptometry.com]
Retinal microaneurysm counts and 10-year progression of diabetic retinopathy. Arch Ophthalmol 1995;113:1386–91. Writing Committee for the Diabetic Retinopathy Clinical Research Network, Gross JG, Glassman AR, et al. [guidelines.diabetes.ca]
- Retinal Scar
Proliferative retinopathy Retinopathy with the growth of new blood vessels (neovascularization). proliferative retinopathy capillary non-perfusion, retinal neoangiogenesis, venous irregularity, cluster haemorrhages and cotton wool spots (retinal scarring [medical-dictionary.thefreedictionary.com]
They will reduce the proliferation without causing retinal scarring or epiretinal membrane formation. [diabeticretinopathy.org.uk]
- Retinal Lesion
Diabetic nonproliferative retinal lesions. Ophthalmology 1987;94:1389–400. Klein R, Moss SE, Klein BE, et al. The Wisconsin epidemiologic study of diabetic retinopathy. XI. The incidence of macular edema. Ophthalmology 1989;96:1501–10. [guidelines.diabetes.ca]
Workup
Workup for diabetic retinopathy includes fasting glucose and hemoglobin A1c measurements. (See Workup.) [emedicine.medscape.com]
Treatment
This represents a feasible option in cases where pain during laser treatment and impairment of vision afterwards due to cystoid macular oedema result in poor compliance with standard laser treatment under topical anaesthesia. [ncbi.nlm.nih.gov]
Abstract The National Diabetic Retinopathy Laser Treatment Audit is a prospective survey of laser treatment for diabetic retinopathy throughout the United Kingdom. [nature.com]
[…] structured re-treatment protocol (n=191 eyes). [visionaware.org]
Prognosis
[…] median age at onset of Type 1 diabetes was 8.4 (interquartile range 4.2-13.3) years in probands and 16.9 (interquartile range 10.2-27.8) years in later-affected siblings (P CONCLUSION: The siblings first affected by Type 1 diabetes had a better long-term prognosis [ncbi.nlm.nih.gov]
The worst prognosis seems to be in age-at-onset group 5–9 years. However, if compared with age at onset 10–14 years, this difference did not reach statistical significance (1.29 [0.98–1.70], P = 0.07). [care.diabetesjournals.org]
In the past, the prognosis for pregnancy in diabetic women with microvascular disease was so poor that many physicians advised avoidance or termination of pregnancy. 2 With the recognition that the level of glycaemia during pregnancy is directly related [bjo.bmj.com]
Etiology
The patient presented 16 months after fetal death of unknown etiology at 26 weeks of gestation with acute visual impairment in both eyes; severe proliferative retinopathy was diagnosed. [ncbi.nlm.nih.gov]
The etiology of this increase involves changes in diet, with higher fat intake, sedentary lifestyle changes, and decreased physical activity. [3, 4] Patients with diabetes often develop ophthalmic complications, such as corneal abnormalities, glaucoma [emedicine.medscape.com]
This can describe etiologies of intraretinal swelling including diabetes, post-surgical macular edema, vein occlusions, and uveitis. [eyeguru.org]
Prolonged hyperglycemia is the major etiologic agent in all of the microvascular complications of diabetes, including diabetic retinopathy. The cellular mechanisms through which hyperglycemia acts currently remain unclear. [retinacenternj.com]
Epidemiology
An epidemiological study. Acta Ophthalmol Suppl 172:1–77 PubMed Google Scholar 13. Green A, Hauge M, Holm NV, Rasch LL (1981) Epidemiological studies of diabetes mellitus in Denmark. II. A prevalence study based on insulin prescriptions. [link.springer.com]
The Wisconsin Epidemiologic Study of Diabetic Retinopathy. VI. Retinal photocoagulation. Ophthalmology 1987; 94 :747–53. 16 Aldington SJ, Stratton IS, Kohner EM, Matthews DR, Turner RC. [nature.com]
Based on epidemiological and pathophysiological findings, risk factors apart from glycemic control and duration of disease are likely to be involved in the development of proliferative retinopathy. [ncbi.nlm.nih.gov]
It aims to cover the entire spectrum of the disease by describing its clinical identification and characterization, pathophysiology, epidemiology, and medical and surgical management. [books.google.com]
In the Wisconsin Epidemiology Study of Diabetic Retinopathy 4-year incidence study, no person (16,20,21). [guidelines.diabetes.ca]
Pathophysiology
However, animal studies are needed to investigate the pathophysiological mechanisms of how postnatal weight gain affects the severity of ROP. [ncbi.nlm.nih.gov]
It aims to cover the entire spectrum of the disease by describing its clinical identification and characterization, pathophysiology, epidemiology, and medical and surgical management. [books.google.com]
Pathophysiology : concepts of altered health states. Wolters Kluwer Health/Lippincott Williams & Wilkins. p. 756. ISBN 9780781766166. OCLC 181600926. ^ "Chapter 10. [en.wikipedia.org]
Prevention
Treating proliferative retinopathy Laser photocoagulation surgery helps to prevent new blood vessels from growing, therefore helping to prevent the complications that can result such as haemorrhage or a detached retina. [diabetes.co.uk]
Intravitreal injection of blocking antibodies to SDF-1 prevented retinal neovascularization in our murine model, even in the presence of exogenous VEGF. [ncbi.nlm.nih.gov]
Early diagnosis and treatment are essential in this disease to enhance a final visual outcome of stabilization and prevention of further loss of vision. [medical-dictionary.thefreedictionary.com]
Diabetic Eye Disease: Proliferative Diabetic Retinopathy Prevention Preventative screening Vision loss due to retinopathy can be prevented through frequent eye examination and timely treatment when proliferative retinopathy or macular oedema is diagnosed [myvmc.com]