What's up, guys? This is Dr. Mário Bulla, and welcome once again to the Retina e Vítreo channel, your main source of information on retinal diseases. Today we're going to address a question that frequently arises among our followers: "Can diabetes cause glaucoma?" Let's understand this relationship better.
#### Glaucoma and Diabetes: Is There a Direct Link?
When it comes to glaucoma, whether open-angle (chronic simple glaucoma) or angle-closure, there has been a lot of controversy over the years. Some studies have suggested that people with diabetes are more likely to develop glaucoma, while others have indicated that there is no such correlation. More recently, research has even suggested that diabetics may be less likely to develop glaucoma. However, most recent studies conclude that there is no significant relationship between diabetes and common glaucoma.
#### Diabetic Retinopathy and Neovascular Glaucoma
Although diabetes itself is not a direct risk factor for common glaucoma, it is directly related to a very serious type of glaucoma, neovascular glaucoma. This type of glaucoma is a serious complication of diabetic retinopathy, a condition that affects the retina of diabetic patients.
Diabetic retinopathy occurs when the blood vessels in the retina are damaged by high blood glucose, resulting in poor circulation and a lack of oxygen in the retina. In response, the body begins to produce new blood vessels (neovessels), a process mediated by vascular proliferation factors such as VEGF1.
#### How Neovessels Affect the Eye
Neovessels are fragile and can cause various problems. They grow on the retina and can cause vitreous hemorrhages, which impair vision. In addition, these abnormal vessels can create fibrous tissues that pull and detach the retina, resulting in tractional retinal detachment, a serious condition that often requires delicate surgery.
More dangerously, these neovessels can grow into the iris and trabecular meshwork, the structure responsible for draining the aqueous humor (the inner fluid of the eye), leading to the clogging of this system and causing neovascular glaucoma. This type of glaucoma can dramatically increase intraocular pressure, often to over 50 mmHg, causing rapid and irreversible loss of vision and intense eye pain.
#### Treatment of Neovascular Glaucoma
Treatment for neovascular glaucoma should be started as soon as possible. Intravitreal injections of antiangiogenics, which reduce the formation of new blood vessels, can be effective at first. If the trabecular meshwork is not yet severely damaged, intraocular pressure can improve significantly with this treatment.
However, in advanced cases, where the trabecular meshwork is fibrous, surgery may be necessary to regulate eye pressure. Surgical options include implanting drainage valves or performing a trabeculectomy, which creates a new drainage route for the aqueous humor.
#### Continuous Monitoring
It is important to note that neovascular glaucoma requires constant and rigorous monitoring, as neovessels tend to reappear, requiring repeated treatments to keep the condition under control. In cases where injections and eye drops are not enough, other techniques, such as cryotherapy and cyclophotocoagulation, can be considered.
Conclusion
Although neovascular glaucoma is a serious condition associated with diabetic retinopathy, advances in medicine, such as antiangiogenic injections, offer hope of effective treatment. However, prevention and continuous monitoring are essential to avoid serious complications. If you have diabetes, it is crucial to have regular eye examinations and follow the recommendations of your ophthalmologist.
If you have any more questions on this subject, please leave a comment. Don't forget to leave a like, subscribe to the channel and see you in the next video here on the Retina e Vítreo channel.
This video and its comments are not a substitute for a doctor's consultation and are for educational purposes only. They should not be used to make decisions, for which a face-to-face consultation with a specialist doctor is necessary.
Author:
Dr. Mário César Bulla
Cremers 28120
Ophthalmologist - Retinologist
www.clinicabulla.com.br
www.especialistaemretina.com.br
Instagram: @retina.bulla
Video URL: • Diabete causa glaucoma ?
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0:00 Can diabetes cause glaucoma?
0:40 Relationship between diabetes and glaucoma.
1:27 Severe glaucoma caused by diabetes: neovascular.