Diabetes becomes one of the most common diseases. Ailment can undermine the health of not only an adult, but also a child. Doctors associate this tendency primarily with many factors that can affect the state of the organism of a modern person: chronic fatigue, all kinds of stressful situations, excess weight, decreased physical activity, a long stay in a sitting position, an unfavorable environment, and poor nutrition.
Why does pathology arise, how does it develop?
In diabetes, the development of retinopathy is a very common scenario in the history of the disease. Of the ten patients, nine in the late stages of the illness have a disability due to vision. The danger of the disease lies in its rapid progression and prolonged asymptomatic. All the causes of retinopathy can be conventionally reduced to one - diabetes. The newly formed vessels are fragile, as they have the thinnest walls and are characterized by fragility due to the single-layer texture. With frequent hemorrhage inside the eye and the ingress of nonabsorbable blood clots, fibrous tissue grows, which ultimately leads to total blindness. This phenomenon in medicine is called hemophthalmus, however, it cannot be called the only cause of vision loss.
Protein fractions seeping from blood plasma through newly formed vessels also lead to blindness. They join the process of scarring of the retina and vitreous body. A lesion of the corneal sheath leads to an impaired sensitivity of the optic nerve, which causes retinal detachment and is the basis for the formation of a neovascular-type glaucoma.
Precursors and symptoms of retinopathy
As already mentioned, the greatest danger of the disease is its protracted hidden course. Symptoms of diabetic retinopathy often manifest themselves when the patient already feels blurred vision, the appearance of stains and veil before his eyes. Because of the damage to the cornea, vision is rapidly reduced, and blindness occurs in a matter of months.
To maintain the ability to see, it is important to pay attention in time to any changes occurring in the organs of vision. For example, in the early stage of retinopathy in diabetes mellitus, patients note the following changes:
- any pictures and images are fuzzy, appear blurry,
- reading and working with small details becomes difficult,
- floating dark spots
- feeling of veil.
Macular retinal edema impedes the normal life of the patient, the implementation of elementary actions close hands. Often patients try not to pay attention to such "signals", writing off their appearance to fatigue, catarrhal diseases, and general malaise.
Factors that provoke vision problems
Retinopathy of the eyes with diabetes mellitus is not a sentence. Practice shows that the predominant number of patients suffering from insulin deficiency for a long time, has varying degrees of damage to the retina and cornea. Thus, the largest percentage of patients suffering from diabetes for over 10 years, notes the maximum severity of symptoms of retinopathy. The conclusion suggests itself: the risk of vision loss increases with each year of the disease. The following factors can accelerate the pathological process:
- persistent hypertension, frequent crises,
- consistently high blood sugar levels
- kidney and liver failure
- increased cholesterol and lipids,
- increase in the ratio of lean body mass and visceral fat,
- disruptions in natural metabolism,
- genetic predisposition
- pregnancy and lactation,
- alcohol abuse and smoking, maintaining an unhealthy lifestyle.
Diagnosis of retinopathy
For regular monitoring of blood sugar levels, the increase in which is the main cause of the progression of retinopathy, it is enough to follow a diet and take supporting medications in a timely manner. Some of the vitamin-mineral complexes containing all the necessary elements for visual acuity, designed specifically for patients with diabetes. In addition, to prevent the development of retinopathy will help regular examination by specialists, the strict implementation of all preventive measures and recommendations aimed at inhibition of pathological processes.
Turning to doctors in case of decrease in visual acuity in diabetes mellitus, you should prepare for the passage of a thorough diagnosis. Before proceeding with the treatment of a disease, a specialist must be convinced of the validity of the intended diagnosis. The results of several research procedures are able to confirm it. In diabetic retinopathy, patients undergo a comprehensive examination, which includes:
- Visometry - using a special table to assess visual acuity,
- perimetry - determination of the viewing angle of both eyes of the patient and each one against the background of corneal lesions (the viewing angle is less than the norm indicates the presence of an eyesore),
- biomicroscopy of the front walls of the eyeballs - modern non-contact type diagnostics for the study of lesions of the retina and cornea, involves the use of a slit lamp,
- diaphanoscopy - a detailed study of the structures of the cornea, the inner part of the eyeball, the determination of the presence or absence of tumors,
- ophthalmoscopy - examination of the fundus of the eye using a special ophthalmic mirror.
In cases of severe corneal, vitreous or lens opacification, an ultrasound examination is mandatory for the patient. Thus, the timely diagnosis of the organs of vision in diabetes mellitus allows not only to identify pathology at an early stage, but also to begin an effective treatment. Diabetic retinopathy requires an individual approach and highly qualified specialists.
Who to contact for the treatment of the disease?
Since visual impairment and retinal damage are secondary, in the treatment of disease, the primary task is to continuously monitor blood sugar levels. Systemic monitoring of renal function and blood pressure also plays an important role in the treatment of retinopathy. In addition to the ophthalmologist, the patient will have to seek professional medical care from other representatives of narrow specializations - an endocrinologist, a diabetologist and a cardiologist. Versatile consultations will help to optimize the treatment plan and maintain the maximum glucose level, find the most appropriate insulin therapy regimen in a specific clinical case.
Laser exposure is the most common and effective way of dealing with diabetic retinopathy. Many people probably have an idea what it is, but still this method of treatment has its own peculiarities. So, laser therapy is also used for macular edema. The task of the procedure is to slow down or completely stop the pathological neovascularization. Laser coagulation helps to strengthen the vascular walls, minimizing permeability and the likelihood of retinal detachment. With this treatment, the doctor has specific goals:
- destruction of zones of oxygen starvation of the retina and cornea - favorable areas for the growth of newly formed vessels,
- oxygen saturation of the retina coming from the vessel lining,
- the implementation of thermal coagulation of new vessels.
In addition, laser intervention by ophthalmologists-surgeons involves the execution in various ways:
- barrier - coagulates are applied multilayered in the form of a grid, this technique is considered particularly effective during the initial stages of retinopathy and the presence of macular edema,
- focal - by cauterization of microaneurysms, hemorrhages, fluids (by the way, the procedure is also used before x-rays of the retinal vessels),
- panretinal - coagulants are applied to the entire retina, most often they are used to prevent retinopathy of the second stage.
To get rid of the preproliferative or proliferative form of the disease, laser coagulates spread over the entire surface of the retina, without affecting its central parts. The newly formed vessels are subjected to focal irradiation by a laser. This technique is classified as a surgical intervention, it is very effective in the early stages of the disease and helps prevent blindness in a predominant number of clinical cases. With the development of macular edema on the background of diabetes mellitus, laser beams affect the center of the retina. Talking about the duration of the therapeutic effect is definitely not possible, because the result of therapy is largely determined by the general well-being of the patient.
Surgical treatment of organs of vision - vitrectomy
Retinopathy in type 2 diabetes mellitus is most often treated by vitrectomy. Doctors make the decision to intervene only in cases where the patient has extensive intraocular hemorrhages. At the advanced stage of the disease, an extremely important point is the prompt elimination of blood clots from the eye cavity, dimmed areas of the vitreous body or its aspiration, which is pumping out of the liquid. Removal of fibrovascular cords from the retina is performed on a full scale, and if possible, the hyaloid membrane located behind the vitreous is affected. By eliminating this part of the organ, specialists can stop the progression of diabetic retinopathy.
What is vitrectomy, and how is the laser treatment of the disease, described above, and then you should proceed to the consideration of conservative therapy. By the way, the use of drugs in diabetic retinopathy and to this day is the reason for the most heated debates. There are no special medications that could stop the pathological processes of visual acuity reduction, and the effectiveness of the use of certain drugs that contribute to the stabilization of the patient’s condition is conditional. Some ophthalmologists are convinced of the appropriateness of the use of drugs as an adjunct to surgical treatment.
Preparations and eye products
In diabetic retinopathy (ICD 10 - H36.0), experts advise the use of drugs that stop current and prevent new lesions of the eye retina:
- "Taufon" is an antioxidant, helps to improve metabolic processes in the structure of the eyeball.
- "Anthocyanin Forte" - vasoconstrictor drops, whose action is aimed at reducing vascular permeability.
- "Emoxipin" - eye drops, often used as a prophylaxis for retinopathy in diabetes mellitus.
In addition, it is possible to increase the level of blood supply to the eye tissues with the help of physiotherapeutic devices. For example, one of the most popular, demonstrating a good result, is the Sidorenko Glasses device, which successfully combines several modes of exposure: phonophoresis, infrasound, color therapy and pneumomassage. The result of treatment, as a rule, exceeds all expectations.
With pronounced bruising, intravitreal administration of enzyme substances contained in the preparations "Gemaza", "Lidaza" is prescribed. At the same time, we should not forget that there are no medicines yet capable of completely preventing the development of retinopathy in diabetes mellitus. In most developed countries, the treatment of the disease is performed surgically and by the method of systematic monitoring of the patient's blood sugar level.
However, the researchers are not idle, the search for effective drugs are ongoing. Despite the fact that the issues of drug therapy of retinopathy and hemophthalmus are practically not considered by domestic and foreign authors, practicing ophthalmologists consider the corresponding developments in this direction to be very promising.
Complications and prevention of the disease
Recovery from a disease such as retinopathy is a difficult and not always feasible task. To stop the pathological process leading to blindness, it is important, first of all, to consult an ophthalmologist and undergo an examination. Thanks to modern technological equipment, it is possible to objectively evaluate the state of the organs of vision, therefore, deciding on the choice of an ophthalmologic clinic to solve health problems, it is important to make it in favor of a high-class institution. It is necessary to take into account not only the cost of treatment at the ophthalmological center, but also its reputation, the reviews of other patients about the quality of medical services.
Diabetes and retinopathy can cause complications in the form of cataracts and secondary glaucoma. That is why systemic monitoring by an endocrinologist and an ophthalmologist is extremely important for patients with such a diagnosis. In addition, in the majority of clinical cases, when timely seeking professional medical care, it is possible to prevent retinal detachment and entry of blood clots into the vitreous, which almost inevitably leads to loss of vision. Meanwhile, the patient has every chance of not knowing what it is - diabetic retinopathy. Its prevention consists in observing two main rules: constant monitoring of blood sugar levels and maintaining normal blood pressure.
Impact of diabetes on vision
In healthy people, the pancreas secretes enough insulin for the metabolism of glucose, protein and fat. Diabetes mellitus is expressed in absolute or partial insulin deficiency, or in the immunity of tissues to this substance. Sometimes these factors are combined in one patient. The easiest way to suspect a diagnosis is to give blood from a finger.
Since insulin is used to transport glucose, when it is deficient, its consumption by tissues decreases and sugar accumulates in the blood. An elevated concentration of unclaimed sugar is called hyperglycemia. There is a serious violation of the metabolism and nutrition of cells. Regardless of the type of diabetes, there will be various tissue or vascular disorders. The type of illness, the effectiveness of insulin therapy and the way of life determine how soon and to what extent the complications will manifest.
Hyperglycemia is a prerequisite for the onset of retinopathy, because proper metabolism is very important for the normal functioning of the visual system. For this reason, many endocrine diseases are complicated by ophthalmologic disorders. Retinopathy is a manifestation of microangiopathy when the patency of the small vessels (capillaries) of the retina is impaired. Such complications are more often diagnosed in people who have been living with diabetes for a long time.
Retinopathy is a dangerous complication of diabetes, since 90% of patients with the first type after 15-20 years of illness have characteristic symptoms.Typically, the defeat of the visual system begins in 5-10 years. With timely examination, it is possible to detect the symptoms of retinopathy even at the earliest stage, therefore all diabetics need to visit an ophthalmologist at least twice a year.
How does diabetic retinopathy develop?
Excess glucose, existing for a long time, leads to a serious disruption of metabolism. Glucose quickly enters into chemical reactions when its concentration exceeds the norm. The negative impact of sugar on the structure of the body - glucose toxicity.
- Glucose binds to proteins, changing their structure and basic functions. Glycosylated proteins destroy the walls of blood vessels, increase the number of platelets, increase the secretion of endothelin. There is a violation of hemostasis and hypercoagulation, microscopic blood clots are formed.
- The oxidative effect on fats, proteins and glucose increases, which provokes oxidative stress. The production of free radicals is sharply increased, and there are more and more highly toxic radicals.
- Intracellular pressure rises as sorbitol and fructose are deposited in the endothelium. Edema develops, the phospholipid and glycolipid composition of cell membranes is disturbed, and capillary membranes thicken.
- The rheological properties of the blood change: a combination of platelets and erythrocytes, the formation of microscopic blood clots, impaired oxygen transport. As a result, retinal hypoxia develops.
Vascular disease in diabetes is associated with hyperglycemia and glucose toxicity. This provokes oxidative stress, excessive production of free radicals and the final hyperglycemic products. Pericytes die, cells that transmit excitement in the vessels. They also regulate fluid exchange by constricting and dilating capillaries.
Through the endothelium of capillaries and pericytes, cellular metabolism is carried out. After pericyte destruction, vessels become thinner and biological fluids begin to leak into other layers of the retina. A negative pressure is created, the vessels stretch and microaneurysms are formed.
Stages of Diabetic Retinopathy
The main factors for the progression of disorders include thinning of the capillary walls, the emergence of microthrombus, and occlusion of the retinal vessels. Various anomalies in the fundus appear, transcapillary metabolism is disturbed, ischemia and oxygen starvation of retinal tissues develop.
With type 1 diabetes, when a person is dependent on insulin injections, retinopathy develops very quickly. In such patients, the disease is often diagnosed already in its advanced form. In the second type (insulin-dependent), changes are localized in the macula, that is, in the center of the retina. Often maculopathy becomes a complication of retinopathy.
The main forms of retinopathy:
- Non-proliferative. Microscopic aneurysms, hemorrhages, edemas, and exudation foci form in the retina. Point hemorrhages (round and dark or in the form of strokes) are located in the center or deep tissues of the retina. The exudate is soft and hard, white or yellowish in color, with a clear or blurred border, located in the center. For nonproliferative form, macular edema is characteristic. At an early stage, vision does not deteriorate. Nonproliferative retinopathy is diagnosed mainly in diabetics with great experience.
- Preproliferative. There are microvascular anomalies, a lot of exudate of different consistency, as well as large retinal hemorrhages.
- Proliferative. Neovascularization of the optic disc and other areas of the retina, there is a hemophthalmos, fibrous tissue foci are formed. New capillaries are fragile, which causes recurrences of hemorrhages. The formation of vitreoretinal tensions with the subsequent retinal detachment is possible. Neovascularization of the iris causes secondary glaucoma. The proliferative form is characterized by severe visual impairment.
The transition from nonproliferative to proliferative form can occur in a matter of months in a young person with hyperglycemia. The main reason for the deterioration of visual function is macular edema (damage to the center of the retina). Late forms are dangerous loss of vision due to the occurrence of hemorrhages, retinal detachment or severe glaucoma.
The clinical picture of different stages of retinopathy
Retinopathy progresses latently, even in a neglected form, it is imperceptible. The severity of violations depends on the duration of diabetes mellitus, glucose levels and blood pressure indicators. Retinopathy worsens during pregnancy as it becomes more difficult to maintain normal sugar levels.
- an increase in the number of signs that were in the first stage,
- uneven expansion of the retinal veins,
- subretinal and preretinal hemorrhages,
- exudative maculopathy,
- ischemia and exudation in the macula,
- diabetic papillopathy with transient puffiness of the optic disc.
At the preproliferative stage, it is necessary to undergo a more thorough examination for ischemic retinal lesions. Ischemia indicates the progression of the disease, the speedy transition to the proliferative form and the development of neovascularization.
The clinical picture of the proliferative stage
- neovascularization of the retina or optic disk,
- large hemorrhages,
- fibrous moorings and films.
Complications of diabetic retinopathy:
- hemorrhages (accumulations of blood from the destroyed capillaries in the preretinal and intravitreal areas),
- tractional detachment (tension from the vitreous body) or regmatogenous, primary,
- neovascularization of the iris, which provokes neovascular glaucoma.
The degree of optical impairment in retinopathy is highly dependent on the state of the macula. A slight decrease in visual function is characteristic of maculopathy and ischemia of the macula. A sharp deterioration (up to blindness) is possible with severe hemorrhage, retinal detachment and glaucoma caused by neovascularization.
Severe blindness in diabetes occurs as a result of cataracts or glaucoma. A diabetic cataract differs from a classic one in that it progresses rapidly (up to a couple of hours at the time of the crisis). Opacification of the lens of this nature is more often detected in girls and girls. It is possible to cure diabetic cataract, the diagnosis consists in carrying out biomicroscopy.
Neovascular glaucoma arises from the proliferation of capillaries and fibrous tissue in the iris and the angle of the anterior segment of the eye. The resulting vascular network is reduced, forming goniosinechia and provoking an intractable increase in pressure in the eyeball. Neovascular glaucoma is a frequent complication of retinopathy that is poorly treated and can cause irreversible blindness.
Symptoms of diabetic retinopathy
Vision problems in diabetes are not noticeable at first. Only over time do tangible symptoms appear, which is why retinopathy is often detected already at the proliferative stage. When edema affects the center of the retina, visual clarity suffers. It becomes difficult for a person to read, write, type text, work with small details or at a very close distance.
When eye hemorrhages in the field of view there are floating spots, there is a feeling of shroud. When the foci dissolve, the spots disappear, but their appearance is a serious reason to contact an oculist. Often in the process of hemorrhage in the vitreous body tension forms, provoking detachment and rapid loss of vision.
Examination of the organs of vision in diabetes
For a long time, diabetic retinopathy does not manifest itself in any way, which complicates the diagnosis and selection of treatment. When treating a person with diabetes, the oculist should clarify the duration and type of the disease, the degree of effectiveness of treatment, the presence of complications and additional pathologies.
In order to prevent the consultation of an ophthalmologist is recommended to all people who have been diagnosed with diabetes. If the initial examination revealed no signs of retinopathy, 1-2 follow-up examinations are prescribed every year. When a nonproliferative form is detected, the check is carried out every 6-8 months. Preproliferative and proliferative forms require control every 3-4 months. Additional examination is necessary when changing therapy.
Since children under 10 are rarely diagnosed with retinopathy, they are examined every 2–3 years. During pregnancy, examinations are shown every trimester, and in case of an interruption - monthly for 3 months.
Complex examinations for diabetic retinopathy:
- checking visual acuity (makes it possible to evaluate the functionality of the center of the retina),
- direct ophthalmoscopy (check for retinal ischemia, detection of abnormal vessels, microaneurysms, retinal hemorrhages, vein deformities),
- biomicroscopy of the anterior segment of the eye and vitreous body,
- gonioscopy (checking the anterior chamber angle)
- perimetry (visual field survey, peripheral vision check),
- tonometry (measurement of eye pressure).
Additional information on the operation of the visual system can be obtained during retinal fluorescence angiography, optical coherence tomography, ultrasound, fluorophotometry, and electroretinography. If necessary, conduct psycho-physiological tests to test color vision, contrast, adaptation.
Signs of retinopathy that are not noticeable with standard checks can be detected during fluorescent angiography. According to the results of this study determine the need for coagulation and the zone of influence. Angiography reliably confirms the diagnosis and makes it possible to estimate the prevalence of ischemia. For fidelity remove the entire periphery of the fundus.
Drug treatment of eye vessels
Conservative therapy for diabetic retinopathy is needed to correct metabolism and minimize hemocirculatory disorders. Use of drugs and physiotherapy. You must understand that drugs are not able to prevent or stop the retinal damage in diabetes mellitus. They are used only as an additional exposure before or after surgery. The overall result depends on the compensation of diabetes, normalization of blood pressure and lipid metabolism.
What drugs are used in diabetic retinopathy:
- inhibitors of enzymes that convert angiotensin I to angiotensin II (Lisinopril),
- correction of lipid metabolism (Lovastatin, Fluvastatin, Simvastatin, Fenofibrate),
- vasodilators, disaggregants (Aspirin, Pentoxifylline),
- antioxidants (vitamin E, Mexidol, Emoxipin, Histochrome),
- thioctic acids as additional antioxidants (lipoic acid, Berlition, Espa-Lipon),
- angioprotectors (ascorbic acid, Rutoside, Etamzilat, dobesilate calcium),
- to improve local metabolism (Retinalamin, Mildronate),
- prophylaxis and treatment of hemorrhages (Prourokinase, Fibrinolysin, Collagenase, Wobenzym),
- glucocorticoids for the treatment of exudative maculopathy (Triamcinolone),
- angiogenesis blockers for the regression of neovascularization (Bevacizumab).
Surgical treatment of diabetic retinopathy
Vitrectomy is used to treat the vitreous, retinal, and macular areas. This method is recommended for chronic edema of the macula, which is caused by tension. Vitrectomy helps to eliminate long-term hemophthalmus and tractional detachment. The operation involves the partial or complete removal of the vitreous body and its replacement with compatible biomaterials.
Vitrectomy is carried out according to plan, but urgent intervention is also possible in case of retinal rupture or the rapid development of retinopathy. Contraindications include the inability to apply anesthesia, severe systemic diseases, problems with blood clotting, malignant tumors in the eye area.
For replacement of the vitreous body using silicone, fluorocarbon emulsions, gas mixtures, salt solutions. They are not rejected by the eye, maintain its normal shape and fix the retina in such a position to stop the detachment. The most suitable is silicone oil, which refracts light well and hardly causes discomfort.
If the cavity is filled with gas, the person will see a veil before his eyes the whole time of its resorption. After a few weeks, the vitreous cavity is filled with fluid from the eye itself.
Prevention of ophthalmic complications in diabetes
Since negative changes from diabetes are unavoidable, screening remains the main prevention of retinopathy. In diabetes of the first type, it is necessary to regularly visit an oculist after 5 years from the onset of the disease. Diabetics of the second type are examined after the diagnosis is clarified. In the future, you need to undergo a deep ophthalmologic examinations on schedule. The ophthalmologist determines the frequency of examinations for each patient individually after the initial examination.
Timely and complete treatment of diabetes mellitus, as well as associated disorders, allows you to delay the development of retinopathy and stop its progression. The patient must learn self-control, follow a diet and a daily regimen, expose himself to adequate physical exertion, stop smoking, increase stress resistance. This is the only way to prevent blindness and disability.
The only method of preventing diabetic retinopathy is the normalization of carbohydrate metabolism. Risk factors include unstable blood pressure and diabetic nephropathy. These conditions need to be controlled as much as diabetes itself.
Traditionally, diabetic retinopathy is ranked as a complication of hyperglycemia. However, in recent years, experts have increasingly come to the conclusion that diabetic retinopathy is not a complication, but an early symptom of diabetes. This allows you to identify the disease at the initial stage and in time to carry out treatment. Expectant tactics are outdated and recognized as dangerous, since earlier diagnostics were carried out when symptoms appeared at the stage of dystrophy progression.
Retinopathy in diabetes mellitus is not the only concomitant disease. As some studies show, by about 2025 a critical mark will be set. Scientists suggest that 300 million people will suffer from diabetes. And this is 5% of the total population of the globe.
Features of diabetes
In order for retinopathy in diabetes mellitus not to develop quickly, it is necessary to know how to prevent it. This requires an understanding of how the ailment works. The main sign of diabetes is an increase in the blood sugar level of the patient. In a healthy person, pancreatic cells produce a hormone - insulin. It is this substance that regulates metabolic processes, primarily sugars, proteins and fats.
Diabetes produces an insufficient amount of insulin. As a result, there are violations not only in terms of metabolism. Blood sugar rises. The cells of the body in such conditions are not able to work normally.
Insulin deficiency leads to impaired fat metabolism, as well as to the accumulation of cholesterol. This substance gradually accumulates on the walls of blood vessels and leads to sad consequences. In diabetes mellitus, the eyes, kidneys, heart, visual apparatus, as well as vessels located in the lower extremities are most often affected.
When does retinopathy occur in diabetes mellitus
After 5-10 years after the first symptoms of diabetes mellitus, a person develops diabetic retinopathy. With type 1 disease, this phenomenon occurs violently.Retinopathy develops rapidly and becomes proliferative. If a patient has type 2 diabetes, then all changes are mostly observed in the central zone of the retina. Often maculopathy develops. It is usually cystic and leads to a deterioration of central vision.
Why does diabetes and related diseases occur?
There were several main reasons why diabetes is developing. By avoiding further aggravation of the disease, the development of retinopathy can be prevented. Among the main reasons:
- Hereditary predisposition
- Pancreatic diseases that cause changes in beta cells, such as cancer, pancreatitis, and so on.
- Viral infections, including influenza, epidemic hepatitis, chicken pox, rubella, and so on. Such diseases are something like a trigger for those who are at risk.
- Nervous stress.
Is it possible to immediately diagnose retinopathy
Retinopathy in diabetes mellitus is not immediately diagnosed, since quite complex processes take place in the patient's body. Often the disease becomes noticeable only after the appearance of some complications. Statistics show that retinopathy in type 1 diabetes mellitus is present in almost 99% of all patients.
This disease is a serious complication. Retinopathy affects primarily vessels located in the retina directly in the eyeball. There is a complication in more than 90% of all patients with diabetes. The main symptom of the disease - the deterioration of visual acuity and impairment, because of which a person stops to see normally. With diabetes mellitus, people most often go blind. Identify the first signs of retinopathy can be. To do this, you must pass a thorough examination by ophthalmologists.
Diabetic retinopathy: symptoms
The disease occurs mainly without obvious symptoms. In the early stages, the patient does not experience vision problems and does not notice a decrease in his sharpness. Retinopathy in diabetes mellitus becomes apparent only after a hemorrhage that occurs inside the eye. At this point, the patient appears a continuous veil and dark floating spots. After some time, these symptoms disappear completely.
However, the hemorrhage passes for the patient without a trace. As a result of this violation, complete loss of vision may occur. Indeed, yarns begin to form inside the vitreous that can lead to retinal detachment.
In addition, there is swelling of the central regions, which are responsible for a person’s ability to read and observe small objects. In such cases, the veil again returns to the eyes. Reading, doing work at close range, as well as sewing, knitting and embroidery become almost impossible.
Diabetic retinopathy, the symptoms of which are described above, has several varieties. The classification of this disease was established in 1992. She was approved by the World Health Organization. This classification is still valid. Retinopathy can be:
- Not profiled This is a kind of pathological change that occurs in the retina. It manifests itself, as a rule, by hemorrhages, microscopic aneurysms, the shape of which is a dark spot or the point.
- Preproliferative. Such retinopathy in diabetes mellitus, a photo of which can be seen below, is a venous anomaly. They have a tortuous contour and loops, a significant amount of exudates. Often, this violation is marked by the occurrence of a large number of large hemorrhages.
- Proliferative. In this case, there is neovascularization of the disc, which is located in the optic nerve. When this occurs, hemorrhage into the vitreous body. As a result, fibrous tissue is formed in the damaged area. The newly created vessels are fragile and very thin walls. It is in them that repeated hemorrhages are observed. Vessels that have formed in the iris, often lead to the emergence of secondary glaucoma.
What is retinopathy in diabetes? The stages of this disease are determined by their characteristic signs. In total, there are three periods of the disease:
- Easy stage. This period is characteristic of non-proliferative retinapathy. This is the earliest stage of the disease. During this period, microaneurysms develop - this is a kind of swelling in the form of balls, formed in small vessels of the retina.
- Moderate stage. With the progression of the disease there is a blockage of blood vessels, which are necessary for normal nutrition of the retina.
- Hard stage. With this ailment, a large number of vessels are blocked. At the same time in the retina there is insufficient blood flow. At this stage, the body receives signals that it is necessary to create new vessels for the resumption of normal tissue nutrition.
Non-proliferative and proliferative retinopathy
Nonproliferative retinopathy in diabetes mellitus is characterized by the formation of an aneurysm in the central zone. It can also occur near large veins that pass through the layers of the retina. At the same time, exudative lesions in the fundus of the eye are noted. As a rule, they have a white or yellow shade, as well as fuzzy borders. With this disease, there is swelling of the retina, located in the central region, as well as in the region of the central and larger vessels. This phenomenon is the main symptom of nonproliferative retinopathy in diabetes mellitus.
As for the proliferative type of the disease, this is the latest stage of the disease. Due to the fact that the retina does not receive enough nutrition, new vessels with fragile and thin walls begin to form. They are often called abnormal. Such vessels grow on the retina, and also cover a significant part of the vitreous body located inside the eye. They are not able to impair vision, but very fragile. Of these, blood is usually leaking. As a result, a visual impairment occurs, which has serious consequences. Often the disease leads to complete blindness.
Basic therapy tips
Retinopathy is treated in case of diabetes mellitus type 2 and type 1 in completely different ways. After all, their symptoms are not the same. In some cases, it is not possible to cure the disease completely without surgery. As a rule, the treatment of the disease is carried out in a complex. The patient before the appointment of treatment should be examined not only by an optometrist, but also by an endocrinologist. If the disease is in the second or in the third stage, then the medication will not be enough. In such a situation, laser retinal photocoagulation is required. This is the most effective method.
Retinopathy in diabetes mellitus, the symptoms of which can only appear at the last stage, is a complex disease. Therapy is carried out with strict observance of insulin therapy, as well as with drawing up the correct diet for the patient. The patient is forbidden to eat in large quantities of animal fats. They are usually replaced by herbal products. Excluded from the diet is easily digestible carbohydrates. With this disease, they are very harmful.
Products and preparations
Treatment of retinopathy in diabetes mellitus is a complex process that requires patience. The first is to make a diet for the patient. Experts recommend eating food that has lipotropic ingredients that are good for the eyes. The patient's menu should include broccoli, black currants, blueberries and viburnum, hot and sweet peppers, Brussels sprouts, sea kale. In addition, foods such as new potatoes, dairy products, liver, fish oil, and so on should be present in the diet.
In addition, it is necessary to take vitamin complexes. Very useful for patients with diabetes mellitus are drugs of group B. They can be taken not only inside, but also parenterally.
On the walls of blood vessels such vitamins as E, P and C have a positive effect. They have a protective effect. Effective angioprotective drugs are Doxium, Ditsinon, Anginin.
Medications should be taken only as prescribed by specialists. Treatment of retinopathy in diabetes mellitus is not only drug use. This disease requires regular and thorough eye examinations. In addition, it is necessary to regularly take tests to determine the level of sugar in the blood.
Herbal preparations from the pharmacy
So, retinopathy in diabetes mellitus, whose symptoms become more pronounced in the latter stages, is a disease that is very difficult to cure. At the pharmacy, you can buy drugs on a plant-based basis. Here is a list of the most effective:
- Tanakan. This drug is prescribed quite often. This drug is made from a plant like ginkgo biloba. Take the drug should be with meals three times a day, one tablet. The course is at least three months.
- "Neurostrong". This is another effective drug. It is made of several components: blueberries, vitamins of group B, ginkgo biloba and lecithin. The drug is able to improve blood circulation, providing cells with normal breathing. This eliminates the risk of hemorrhage and blood clots. Assign "Neurostrong" up to 4 times during the day one tablet.
- "Dibikor." Retinopathy with diabetes mellitus retreats before such a drug. How to treat the disease with this tool? Prescribe the drug in half a gram to two times a day. To use the drug should be about 20 minutes before the morning and evening meals. The course is 6 months. The tool can improve metabolism and saturate the cells of tissues with useful components.
Scarlet at ailment
Retinopathy in diabetes mellitus type 2, the treatment of folk remedies which is allowed, can cause serious consequences. Alternative medicine drugs are usually used to prevent illness. If the symptoms of the disease have not yet manifested or the ailment is at the initial stage, then you can try aloe-based products.
This plant has unique properties and is used to treat many problems. In order to prepare the drug, you need aloe, whose age does not exceed three years. The plant should be carefully examined and select healthy and fleshy leaves. They should be thoroughly washed and then wrapped in paper. It is better to use parchment. The resulting raw materials should be held for some time on the bottom shelf of the refrigerator. To be more precise, it will take about 12 days. Only after that the leaves of aloe can be crushed. For this it is better to use a meat grinder or a blender.
The resulting mass should be squeezed using gauze. Juice must be filtered, using a sufficiently dense cloth, and then put on fire and bring to a boil. The resulting composition should be cooked for about three minutes.
Keep the juice ready for a long time can not be. The drug begins to lose its properties very quickly. Therefore, it is better to prepare in this way before the reception. Take aloe juice three times a day for a teaspoon half an hour before meals. In addition, the drug can be instilled into the eyes. This should be done at night. A few drops will be enough. However, when digging in it is worth being careful. To carry out such therapy is only with the permission of the attending physician.
Infusions and juices
How else is retinopathy removed in case of diabetes? Treatment with folk remedies is usually prescribed to maintain the condition of the patient, as well as for prevention. If the disease is at an early stage, then such drugs can stop its further development. In unconventional medicine used various herbal infusions.
One of the most effective is a calendula-based product. For its preparation it is necessary to chop the flowers of this plant and pour hot water. Half a liter of boiling water requires three teaspoons of raw materials. Grass container should be wrapped and infused for three hours. The finished composition is well strain. Take calendula infusion need up to four times a day for ½ cup. The same drug of alternative medicine can be used for eye instillation.
A good effect and has an infusion made from blueberries. For the preparation of this drug is required to fill a glass of boiling water with a tablespoon of berries. Infuse the drug should be within an hour. Ready remedy need to drink for the day.
Juices from various berries are also useful. After all, they contain a large number of useful components. To combat retinopathy in diabetes, you can use a drink made from cranberries. It should be noted that the daily use of such juice helps to overcome even the cartiopathy at the initial stage.
To eliminate retinopathy in diabetes, you can use various fees. If desired, this tool can be prepared independently. Here is one of the effective recipes of alternative medicine.
For cooking you will need: chopped burdock root, chopped leaves, as well as willow bark, bean leaves, knotweed, bearberry, nettle, walnut, birch leaves and mint. Components must be taken in equal proportions. In a deep container you should combine all the ingredients of the collection, and then mix. A tablespoon of the mixture is worth brew half a liter of boiling water. The drug should be infused for an hour. After that, you need to filter it. To use this collection should be half a glass, preferably before a meal. The course is at least 3 months. The effect will be reached if to use means without interruption. Now you know what retinopathy is in diabetic patients. Do not forget that any therapy with unconventional methods should not be carried out without the advice of specialists. Otherwise it can only hurt.