DIABETIC RETINOPATÍA

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	DIABETIC RETINOPATÍA
	*DIABETIC RETINOPATÍA*

DIABETIC RETINOPATÍA

Diabetic Retinopatía

The proliferation and affectation of the blood vessels of the interior of the eye by the diabetes mellitus produces the diabetic retinopatía.

Causes

The diabetes is a general disease that has like more important complication the loss of vision.

The excess of sugar (glucose) in the blood causes important injuries in the blood vessels of all the organism.

These injuries are pronounced with special intensity at level of the retina, which causes the appearance of the denominated diabetic retinopatía.

Its appearance is in relation to the time of evolution of the diabetes and with the degree of control of the numbers of glucemia.

Whatever more years of whichever evolution and worse are the control, greater affectation of the retina.

Signs and symptoms

The diabetic retinopatía is divided in two types:

Nonproliferativa the diabetic retinopatía, in which the vision diminishes by an alteration of the central zone of the denominated retina spot.

The loss of vision is relatively fast, and continuous.

It affects the first by day and fine vision.

Finally the vision is reduced to the resistances between light and shades, and to the forms of the things.

The proliferativa diabetic retinopatía, in which the vision diminishes by the appearance of hemorrhages and new blood vessels inside the vitreous cavity (later camera of the eye).

The loss of vision takes place by stages, according to is taken place the hemorrhages, noticing blurred zones in the field of view, that are extended in size and number.

It causes loosenings of retina very frequently.

Factors of risk

Mellitus diabetes badly controlled.

Other factors that affect the blood vessels, like:

Tabaquismo.

Obesity.

Hiperlipidemia (high cholesterol).

Arterial hypertension.

Prevention

An optimal control of the diabetes is the best possible preventive measure, although it will not avoid the parición of this complication, but it will delay it and slow down its evolution to a great extent.

The other factors of risk will have also to be controlled already mentioned.

In order to prevent the diminution with the vision, it is necessary to make oftalmológicos controls to all the diagnosed patients of diabetes, although they refer to have a good visual sharpness.

The alterations of the vision, when they appear, already indicate an advanced state of the disease and in most of the cases, the medical performance can go directed to maintain the situation, but not to only improve it.

Diagnosis and treatment

Ideally, the diagnosis will be made before visual deficiencies notice, by means of periodic ocular examinations.

In some patients, a normal clinical exploration is not sufficient to value of correct form the injuries that present/display and is necessary to make an angiography with fluorescein to make specific them.

When the diabetic retinopatía is diagnosed of precocious form, effective methods exist to avoid the visual deterioration.

Treatment

The treatment of the diabetic retinopatía is based in the first place on the strict control of the numbers of glucemia. In order to obtain this objective, it is fundamental the work of the attending physician and/or endocrinólogo, as well as the collaboration of the patient.

Nowadays, the most effective technique stops of the treatment of the diabetic retinopatía is the fotocoagulación with Argon laser.

The treatment with laser must be precocious possible and is able to stop the development of the retinopatía.

Diverse techniques of fotocoagulación exist and the ophtalmologist will seat the indication depending on the situation of each patient.

In many cases it is necessary to make several sessions of laser to complete the treatment.

Another possibility is the Vitrectomía, (technical surgical in which the vitreous humor is replaced, gel that fills up the later part of the eye, by an artificial polymer) that is used for example when the vitreous hemorrhages are not reabsorven after a certain time.

Complications

The incidence of blindness by diabetic retinopatía has in the last increased to years thanks to the greater life expectancy of the diabetic patients, being necessary therefore, to progress in the precocious diagnosis of the ocular complications of the diabetes.

The most frequent complications of the diabetic retinopatía are:

The vitreous hemorrhage:

bled within the eye

one is red and stumped

it can leave spots permanent that make difficult the vision.

The loosening of retina:

The layer that at heart catches the light of the eye breaks, taking off itself: blurred and changing vision

if it is not solved quickly, the receivers of the light the generous zone dies, having left blind person

if the spot is affected (zone of the finest vision), the loss of Vista is very important

Prognosis

Detected on time he is controlable, although nonrecoverable.

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