Diabetic Retinopathy

Diabetic retinopathy is the leading cause of new blindness in working-age adults. Stages: (1) nonproliferative (background): microaneurysms, dot-blot hemorrhages, hard exudates, venous dilatation; (2) preproliferative: cotton-wool spots, intraretinal microvascular abnormalities, intraretinal hemorrhages; (3) proliferative: neovascularization on disc/retina, vitreous/preretinal hemorrhage, fibrovascular proliferation, tractional retinal detachment. Diabetic macular edema (focal/diffuse) is the main cause of vision loss. Risk: duration of diabetes, poor glycemic control, hypertension, pregnancy, dyslipidemia. Annual retinal screening; treat by retinal photocoagulation, anti-VEGF intravitreal injection, vitrectomy.

Common Symptoms

Asymptomatic early; blurred vision; floaters; visual-field defects; sudden vision loss from vitreous hemorrhage/detachment; macular edema causes central vision loss

Causes and Pathogenesis

Chronic hyperglycemia damages retinal pericytes/endothelium, causing capillary occlusion, retinal ischemia, VEGF-driven neovascularization, leakage and fibrosis; blood-retinal-barrier breakdown causes edema.

Treatment

Intensive glycemic/BP/lipid control; annual screening; focal/grid laser; intravitreal anti-VEGF (ranibizumab/aflibercept) for macular edema/proliferative disease; panretinal photocoagulation; vitrectomy for hemorrhage/detachment

Preventive Measures

Annual dilated retinal exam; tight glycemic control; BP control; manage dyslipidemia; treat early before vision loss.

Department to Visit

It is recommended to visit the Ophthalmology department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.