Retinopathy

Introduction to retinopathy Retinopathy is also known as Rieger central retinitis, young hemorrhagic macular degeneration. The disease is an arc-like exudative chorioretinal lesion occurring in and around the macula, accompanied by subretinal neovascularization and hemorrhage. It is not uncommon in clinical practice. It is usually caused by monocular disease and is more than 50 years old. It is currently thought to be caused by the growth of new blood vessels under the retina under the macula, which is derived from the choroid. Because retinopathy is mostly a complication of diabetes, diabetes and blood pressure should be controlled mainly. Diabetes control and complication examination confirm that intensity insulin therapy can delay the onset and slow down the progression of diabetic retinopathy, nephropathy and neuropathy in IDDM patients. Visual symptoms include blurred vision, sudden loss of vision in one or both eyes, and black spots or flashes in the field of vision, all of which should be consulted by an ophthalmologist at any time. basic knowledge The proportion of illness: 0.012% Susceptible people: no special people Mode of infection: non-infectious Complications: Diabetes Retinal detachment Retinal tears

Causes of retinopathy

Cause

The exact pathogenesis of GRP is not well understood. The detailed details of the relevant hematological abnormalities in the onset are to be elucidated. It is known that cream hyperglycemia causes a variety of biochemical and physiological changes, which in turn cause damage to capillary endothelial cells. Pathological changes in retinal capillaries include decreased pericytes, thickening of the basement membrane, reduction of the capillary lumen, and decompensation of the capillary endothelial barrier (the blood-retinal barrier).

Diabetic retinopathy is caused by diabetes. In addition to systemic symptoms characterized by polydipsia, polyphagia, polyuria, urinary glucose, and elevated blood glucose, there are bright red capillary hemangioma in both eyes, flaming hemorrhage, and grayish white in the later stage. Exudation, formation of bright red neovascularization, and fundus changes, which are prone to vitreous red blood, are meaningful for diagnosis and estimation of prognosis. The older the patient, the longer the course of the disease, the higher the incidence of fundus. Younger people are more at risk than older patients, and their prognosis is often poor. If diabetes can be controlled in time, not only will there be fewer chances, but also damage to the retina will be less, or retinopathy will gradually worsen, repeated bleeding, resulting in retinal proliferative changes, even retinal detachment, or complicated cataract.

Retinopathy prevention

Because retinopathy is mostly a complication of diabetes, diabetes and blood pressure should be controlled mainly. Diabetes control and complication examination confirm that intensity insulin therapy can delay the onset and slow down the progression of diabetic retinopathy, nephropathy and neuropathy in IDDM patients. Visual symptoms include blurred vision, sudden loss of vision in one or both eyes, and black spots or flashes in the field of vision, all of which should be consulted by an ophthalmologist at any time.

Retinopathy complications Complications, diabetic retinal detachment, retinal tears

Retinopathy usually occurs as an ocular complication of diabetes.

Retinopathy symptoms common symptoms spotted bleeding visual distortion visual impairment

The central vision is diminished, there is a central dark spot, the object is deformed, the vitreous is non-inflammatory, the fundus has yellow-gray exudative lesions and hemorrhage in the macula, round or elliptical, the boundary is unclear, the micro-uplift, the size is about 1 /43/2 optic disc diameter (PD), which is more common than 1PD. There are curved or ring-shaped hemorrhage at the edge of the lesion. Occasionally, there is a point-like hemorrhage in the radial arrangement. There is a pigment disorder zone in the periphery of the lesion. The fovea is centered and the radius is 1PD. At the end of the disease, the macular area forms a yellow-white scar.

Examination of retinopathy

Patients with retinopathy should do some basic and specialist examinations. The basic examinations include:

1, blood sugar check: regular blood glucose levels to monitor the development of diabetes.

2, renal function test: timely detection of complications of diabetic nephropathy.

3, cholesterol lipid test: maintain normal levels of cholesterol and blood lipids.

Ophthalmic examinations include:

1. Fundus fluorescein angiography

Fundus fluorescein angiography can not only understand the early changes of retinal microcirculation, but also have various special manifestations in the progression of diabetic retinopathy. The rate of positive signs is higher than that of ophthalmoscopy. It is an early diagnosis and treatment option. A reliable basis for evaluating efficacy and prognosis. If diabetic retinopathy has not been found under the ophthalmoscope, fundus fluorescein angiography may have abnormal fluorescence patterns. Microangiomas found under fundus fluorescein angiography are much earlier than those seen under ophthalmoscopy. Others such as telangiectasia, increased permeability, no perfusion area, arteriovenous abnormalities, exudation and hemorrhage, neovascularization, etc., fundus fluorescein angiography has a special performance.

2. Electroretinogram oscillation potential (OPs)

OPs is a subcomponent of electroretinogram (ERG), which can reflect the inner circulation of the retina in an objective and sensitive manner. In the eyes where no lesions are seen in the fundus, it can reflect the abnormal amplitude of OPs. In patients with diabetic retinopathy, it can further show the progression and improvement of the disease course.

3. Other inspections

For example, visual contrast sensitivity examination shows that the average contrast sensitivity of middle and high spatial frequencies in early patients is significantly reduced. Color Doppler flow imaging can be used to detect hemodynamic changes in the posterior arteries of patients, which is characterized by low flow rate and low flow. High-resistance type changes in blood viscosity can be expressed as increased viscosity. Serum SOD activity can be measured as decreased viability.

Fluorescent fundus angiography, in the early arterial or arterial phase, corresponds to a variety of vascular network in the form of granules, laces, etc. The hemorrhage area obscures the fluorescence, and the upper edge of the bleeding has a translucent fluorescent area. In the late neovascularization, fluorescein leakage forms a strong fluorescent region.

Diagnosis and diagnosis of retinopathy

According to clinical manifestations, the diagnosis of this disease is not difficult, but should be distinguished from the following several lesions.

1. The lower part of the lower part of the retina is detached, and the macula can be affected by the disease. If you only see the small pupil examination of the ophthalmoscope, it is often misdiagnosed. Therefore, it is found that there is a shallow detachment of the neuroepithelial layer in the macula, especially if there is radiation wrinkles below it, and it is necessary to dilate the periphery of the fundus.

2. The middle part of uveitis or peripheral uveal retinitis, ciliary body flattening inflammation, its pathological toxicity products from the posterior chamber through the Berger gap, along the Cloquer tube back into the macula, causing edema, resulting in small vision, Symptoms such as visceral diseases. However, there is dusty turbidity in the vitreous of the front part of the disease, and sometimes a small amount of post-corneal deposits; the posterior capsule of the crystal (ie, within the Berger gap) has a punctate inflammatory exudate. After full expansion, a three-sided mirror is used to detect inflammatory exudation, hemorrhage, and retinal white sheath near the serrated edge.

3. To identify with retinal vein occlusion, hypertensive retinopathy, and hypoperfusion retinopathy.

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