Diabetic retinopathy

diabetic macular edemaretinopathydamage to the eyesDiabetesdamage to the retinadamage to the retina of the eyediabetes mellitus with ophthalmic manifestationsdiabetic macular edema diseasediabetic macular oedemaeyes
Diabetic retinopathy, also known as diabetic eye disease, is a medical condition in which damage occurs to the retina due to diabetes mellitus.wikipedia
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Diabetes mellitus

diabetesdiabeticdiabetics
Diabetic retinopathy, also known as diabetic eye disease, is a medical condition in which damage occurs to the retina due to diabetes mellitus.
Serious long-term complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, and damage to the eyes.

Visual impairment

blindblindnessvisually impaired
It is a leading cause of blindness.
Other disorders that may cause visual problems include age related macular degeneration, diabetic retinopathy, corneal clouding, childhood blindness, and a number of infections.

Fluorescein

fluorescein-5-isothiocyanateFITCfluorescein dye
If there is reduced vision, fluorescein angiography can show narrowing or blocked retinal blood vessels clearly (lack of blood flow or retinal ischemia).
Intravenous or oral fluorescein is used in fluorescein angiography in research and to diagnose and categorize vascular disorders including retinal disease macular degeneration, diabetic retinopathy, inflammatory intraocular conditions, and intraocular tumors.

Vitreous hemorrhage

In the second stage, abnormal new blood vessels (neovascularisation) form at the back of the eye as part of proliferative diabetic retinopathy (PDR); these can burst and bleed (vitreous hemorrhage) and blur the vision, because these new blood vessels are fragile.
The most common cause found in adults is diabetic retinopathy.

Retina

retinal diseasesretinasretinal
Diabetic retinopathy, also known as diabetic eye disease, is a medical condition in which damage occurs to the retina due to diabetes mellitus.
Both hypertension and diabetes mellitus can cause damage to the tiny blood vessels that supply the retina, leading to hypertensive retinopathy and diabetic retinopathy.

Fundus photography

fundus cameraretinal photographydigital photography
The only way to detect NPDR is by fundus photography, in which microaneurysms (microscopic blood-filled bulges in the artery walls) can be seen.
In patients with diabetes mellitus, regular fundus screening examinations (once every 6 months to 1 year) are important to screen for diabetic retinopathy as visual loss due to diabetes can be prevented by retinal laser treatment if retinopathy is spotted early.

Clostridium novyi

C. novyi
On funduscopic exam, a doctor will see cotton wool spots, flame hemorrhages (similar lesions are also caused by the alpha-toxin of Clostridium novyi), and dot-blot hemorrhages.
Injection into the eye resulted in lesions similar to flame haemorrhages found in diabetic retinopathy.

Macular edema

cystoid macular edemamacular oedemaretinal edema
Even macular edema, which can cause rapid vision loss, may not have any warning signs for some time.
Diabetic retinopathy

Teleophthalmology

EyeCheck
In the UK, this is recommended every year Teleophthalmology has been employed in these programs.
Current teleophthalmological solutions are generally focused on a particular eye problem, such as diabetic retinopathy, retinopathy of prematurity, macular degeneration, strabismus and adnexal eye diseases.

Cotton wool spots

cotton-wool spotcotton-wool spots
On funduscopic exam, a doctor will see cotton wool spots, flame hemorrhages (similar lesions are also caused by the alpha-toxin of Clostridium novyi), and dot-blot hemorrhages.
In diabetes they are one of the hallmarks of pre-proliferative retinopathy.

Blood–retinal barrier

blood-retinal barrierblood retinal barrierblood–retina barrier
The earliest changes leading to diabetic retinopathy include narrowing of the retinal arteries associated with reduced retinal blood flow; dysfunction of the neurons of the inner retina, followed in later stages by changes in the function of the outer retina, associated with subtle changes in visual function; dysfunction of the blood-retinal barrier, which protects the retina from many substances in the blood (including toxins and immune cells), leading to the leaking of blood constituents into the retinal neuropile.
Diabetic retinopathy, eye damage that frequently occurs as a result of diabetes, is related to the breakdown of the blood–retinal barrier.

Pericyte

pericytesperivascularCadriac pericytes
Later, the basement membrane of the retinal blood vessels thickens, capillaries degenerate and lose cells, particularly pericytes and vascular smooth muscle cells.
The retina of diabetic individuals often exhibits loss of pericytes, and this loss is a characteristic factor of the early stages of diabetic retinopathy.

Asymptomatic

subclinicalno symptomssub-clinical
Even so, the advanced proliferative diabetic retinopathy (PDR) can remain asymptomatic for a very long time, and so should be monitored closely with regular checkups.
Diabetic retinopathy

Laser coagulation

laser photocoagulationphotocoagulationlight coagulation
Laser photocoagulation can be used in two scenarios for the treatment of diabetic retinopathy.
The procedure is used mostly to close blood vessels in the eye, in certain kinds of diabetic retinopathy; it is no longer used in age related macular degeneration in favor of anti-VEGF drugs.

Retinal detachment

detached retinadetached retinasretinal tear
Fibrovascular proliferation can also cause tractional retinal detachment.
Diabetic retinopathy

Endostatin

endostatinsendostain
This protection appears to be due to the elevated levels of endostatin, an anti-angiogenic protein, derived from collagen XVIII.
Down's syndrome patients seem to be protected from diabetic retinopathy due to an additional copy of chromosome 21, and elevated expression of endostatin.

Glaucoma

open-angle glaucomaangle closure glaucomaacute angle-closure glaucoma
The new blood vessels can also grow into the angle of the anterior chamber of the eye and cause neovascular glaucoma.
Other factors can cause glaucoma, known as "secondary glaucoma", including prolonged use of steroids (steroid-induced glaucoma); conditions that severely restrict blood flow to the eye, such as severe diabetic retinopathy and central retinal vein occlusion (neovascular glaucoma); ocular trauma (angle-recession glaucoma); and inflammation of the middle layer of the pigmented vascular eye structure (uveitis), known as uveitic glaucoma.

Ophthalmoscopy

ophthalmoscopefundoscopyfundoscopic
On funduscopic exam, a doctor will see cotton wool spots, flame hemorrhages (similar lesions are also caused by the alpha-toxin of Clostridium novyi), and dot-blot hemorrhages.
In patients with diabetes mellitus, regular ophthalmoscopic eye examinations (once every 6 months to 1 year) are important to screen for diabetic retinopathy as visual loss due to diabetes can be prevented by retinal laser treatment if retinopathy is spotted early.

Bevacizumab

Avastin
There are good results from multiple doses of intravitreal injections of anti-VEGF drugs such as bevacizumab.
Many diseases of the eye, such as age-related macular degeneration (AMD) and diabetic retinopathy, damage the retina and cause blindness when blood vessels around the retina grow abnormally and leak fluid, causing the layers of the retina to separate.

Ophthalmology

ophthalmologistophthalmicoculist
Before using the laser, the ophthalmologist dilates the pupil and applies anaesthetic drops to numb the eye.
Diabetic retinopathy

Vitrectomy

pars plana vitrectomyDiamond vitrectomy cutterremoves the vitreous humor
These three treatments are laser surgery, injection of corticosteroids or anti-VEGF agents into the eye, and vitrectomy.
Diabetic retinopathy – may damage sight by either a non-proliferative or proliferative retinopathy.

Fluorescein angiography

fluorescent angiographyFluoresceinangiography
Fundus Fluorescein angiography (FFA): This is an imaging technique which relies on the circulation of fluorescein dye to show staining, leakage, or non-perfusion of the retinal and choroidal vasculature.
Among the common groups of ophthalmologic disease, fluorescein angiography can detect diabetic retinopathy (neovascularization), vein occlusions, retinal artery occlusions, edema of the optic disc, and tumors.

Ranibizumab

A 2017 systematic review update found moderate evidence that aflibercept may have advantages in improving visual outcomes over bevacizumab and ranibizumab, after one year.
A 2017 systematic review update found that while ranibizumab and bevacizumab provide similar functional outcomes in diabetic macular edema, there is low-certainty evidence suggesting that ranibizumab is more effective in reducing central retinal thickness than bevacizumab.

Vascular endothelial growth factor

VEGFvascular endothelial growth factor (VEGF)endothelial growth factor
There are good results from multiple doses of intravitreal injections of anti-VEGF drugs such as bevacizumab. Since 2008 there have been other therapies (e.g. kinase inhibitors and anti-VEGF) drugs available.
VEGF-A is also important in diabetic retinopathy (DR).

Aflibercept

A 2017 systematic review update found moderate evidence that aflibercept may have advantages in improving visual outcomes over bevacizumab and ranibizumab, after one year.
A 2017 review update studying the effects of anti-VEGF drugs on diabetic macular edema found that while all three studied treatments have advantages over laser therapy, there was moderate evidence that aflibercept is significantly favored in all measured efficacy outcomes over ranibizumab and bevacizumab, after one year.