Diabetes mellitus is one of the leading causes of irreversible blindness worldwide and in the United States; it is the most common cause of blindness in people younger than 65 years of age. Diabetes mellitus can cause a wide spectrum of vision problems from temporary blurring of the vision to serious and permanent loss of vision. Severe diabetic retinopathy most commonly develops in people who have had diabetes mellitus for many years and who have had little or poor control of their blood sugars over that period of time.
Hyperglycemia can lead to an accumulation of sorbitol or advanced glycation end products which lead to a weakening of capillary walls. These small blood vessels may begin to "balloon," forming what are called microaneurysms, as well as edema and hemorrhages into the retina. As a response to decreased oxygen delivery to the retina, new blood vessels may begin to grow, a process called proliferative diabetic retinopathy. The new blood vessels are extremely leaky and fragile, potentially leading to bleeding inside the eye. In cases of severe proliferative diabetic retinopathy, new blood vessels may grow on the surface of the iris, causing neovascular glaucoma, a particularly severe form of glaucoma.
TREATMENT:
Intensive control of blood glucose
Blood pressure control
ACE-inhibitors
Foal macular laser
Pan Retinal Photocoagulation and new Targeted Retinal Photocoagulation in which laser is only applied to ischemic areas of the retina.
Attribution: Eye physician and surgeon specializing in: cataracts, glaucoma, diabetic retinopathy, macular degeneration, eye trauma, eye diseases, eyelid disorders.
Marc H. Shomer, MD, PhD Eye Physician and Surgeon The opinions expressed by the Correspondents and those providing comments are theirs alone, and do not reflect the opinions of the nSphere or any employee thereof. All data and information provided on this site is for informational purposes only. nSphere makes no representations as to accuracy, completeness, currentness, suitability, or validity of any information on this site and will not be liable for any errors, omissions, or delays in this information or any losses, injuries, or damages arising from its display or use. All information is provided on an as-is basis. For any questions or to become a Correspondent yourself, please contact us at 617.933.7516.