Diabetic retinopathy is essentially a microangiopathy. The vessels of the retina are easily visible during eye examination (fundoscopy) and therefore patients with diabetes should undergo regular eye examinations in order to detect any signs of vasculopathy, which may involve other target organs.
The incidence of diabetic retinopathy among diabetic patients varies from study to study, but worldwide it reaches about 27-30%. It is more common in type 1 diabetes than in type 2. However, 30% of people diagnosed with type 2 diabetes experience some of the clinical manifestations of diabetic retinopathy at the time of diagnosis.
The main risk factor for developing diabetic retinopathy is the duration of the disease. Other risk factors include poor diabetes control, hypertension, hyperlipidemia, pregnancy, etc.
According to the ETDRS study, the classification of diabetic retinopathy is as follows:
- Non- proliferative diabeticretinopathy (very mild, mild, moderate, severe, very severe).
- Proliferative diabetic retinopathy (moderate-mild, high-risk, advanced diabetic disease).
A key feature of the proliferative form is the presence of neovascularization (pathological new vessels) in the optic disc and/or elsewhere in the retina.
Diabetic macular edema is the most common cause of vision impairment in diabetic patients.
Depending on the stage of diabetic retinopathy and the general condition of the diabetic patient, the schedule for re-screening and, if treatment is required, the treatment regimen is determined.
Proper blood sugar regulation is crucial.
Treatment options for the eyes include administration of anti-angiogenic (anti-VEGF) agents or dexamethasone implant intravitreal, laser application and retinal surgery (vitrectomy).