Pathogenesis (disease development) Diabetic retinopathy will be divided into: Nonproliferative diabetic retinopathy (NPDR) – it forms on the retina (retina): Microaneurysms (bulge in the vascular wall of the capillaries) and pinpoint hemorrhages. Exudation of lipids, resulting in so-called hard exudates. The disease remains confined to the retina; usually occurs earlier and may progress to the … Diabetic Retinopathy: Causes
General measures Aim for normal weight! Determination of BMI (body mass index, body mass index) or body composition by means of electrical impedance analysis and participation in a medically supervised weight loss program. Nicotine restriction (refrain from tobacco use). Conventional non-surgical therapy methods Application of IEGF inhibitors (drugs that inhibit vascular endothelial growth factor (VEGF)); … Diabetic Retinopathy: Therapy
1st order Panretinal laser therapy (coagulation of the entire retina (retina) except the macula/site of sharpest vision); indications: Proliferative diabetic retinopathy (PDR): Panretinal laser therapy should be performed Nonproliferative diabetic retinopathy (NPDR): Panretinal laser therapy should not be offered in cases of mild or moderate NPDR In severe NPDR, panretinal laser coagulation may be considered … Diabetic Retinopathy: Surgical Therapy
To prevent diabetic retinopathy, attention must be paid to reducing individual risk factors. Behavioral risk factors Diet Magnesium deficiency Consumption of stimulants Tobacco (smoking) Therapy of diabetes mellitus – with optimally adjusted glucose serum level, the disease can be delayed.
Changes in the eyes go unnoticed for a long time. Morphologic change, however, often precedes functional deterioration. Only late do the following symptoms and complaints indicate diabetic retinopathy: Leading symptoms General visual deterioration in the sense of blurred vision. Distorted vision (metamorphopsia) Color sense disorders “Sooty rain” in front of the eye due to vitreous … Diabetic Retinopathy: Symptoms, Complaints, Signs
Medical history (history of illness) represents an important component in the diagnosis of diabetic retinopathy. Family History Are there any diseases (diabetes mellitus, ocular diseases) in your family that are common? Social history Current anamnesis/systemic anamnesis (somatic and psychological complaints). What symptoms have you noticed? Do you suffer from blurred/distorted vision? Have you noticed any … Diabetic Retinopathy: Medical History
Eyes and ocular appendages (H00-H59). Retinopathia pigmentosa – congenital disease with gradual destruction of the retina. Retinopathia praematurorum – retinal damage in premature births. Retinopathy due to eclampsia – retinal damage due to a condition occurring during pregnancy with edema (water retention), proteinuria (increased excretion of protein in the urine) and hypertension (high blood pressure). … Diabetic Retinopathy: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by diabetic retinopathy: Eyes and ocular appendages (H00-H59). Ablatio retinae (retinal detachment). Amaurosis (blindness) (0.2-0.5% of people with diabetes). Diabetic cataract (diabetes-related cataract). Diabetic maculopathy (disease of the macula; macular edema or ischemic damage to the macula/site of sharpest vision at … Diabetic Retinopathy: Complications
Stages or severities of nonproliferative diabetic retinopathy (NPDR). Stage Designation Description I mild NPDR Only isolated microaneurysms (tiny bulges on fine blood vessels) II moderate NPDR Fewer microaneurysms and intraretinal (“affecting within the retina”) hemorrhages than in severe NPDR, pearly veins in 1 quadrant at most III heavy NPDR At least one of the following … Diabetic Retinopathy: Classification
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height; further: Inspection (viewing). Skin and mucous membranes Eyes Ophthalmic examination – including determination of visual acuity, examination of the anterior segments of the eye and binocular examination of the retina (retina) with … Diabetic Retinopathy: Examination
1st order laboratory parameters – obligatory laboratory tests. Fasting glucose (fasting blood glucose). HbA1c (long-term blood glucose value) Lipid metabolism parameters – total cholesterol, LDL and HDL cholesterol, triglycerides.
Therapeutic target To prevent or slow progression (progression) of diabetic retinopathy by consistent glucose (blood glucose) and blood pressure regulation. If necessary, also lowering elevated blood lipids (blood fats)* . * No longer considered a risk factor according to an international case-control study of 2,535 type 2 diabetes patients. Therapy recommendations Diabetic macular edema (swelling … Diabetic Retinopathy: Drug Therapy
