What's up, guys? This is Dr. Mário Bulla. Welcome to the Retina e Vítreo channel, your complete source of information on the retina and ophthalmology in general. Today, we're going to cover an extremely important topic: diabetic retinopathy, one of the main causes of blindness in people of working age.
*Introduction to Diabetic Retinopathy*
Diabetic retinopathy is a complication of diabetes that affects the eyes. It is characterized by damage to the blood vessels in the retina, the light-sensitive layer at the back of the eye. This problem can occur in people with both type 1 and type 2 diabetes. Due to high blood sugar levels, the blood vessels in the retina can suffer micro-damage, leading to serious vision problems.
*Causes and Mechanisms of Diabetic Retinopathy*
High blood glucose levels are the main cause of retinal damage. When these levels are high for long periods, blood vessels can become fragile and start to leak. In response, the body tries to form new blood vessels, but these new vessels are abnormal and prone to leaking and bleeding.
There are two main mechanisms by which diabetic retinopathy impairs vision:
1. **Neovascularization: The formation of abnormal new blood vessels, which can lead to vitreous hemorrhages, retinal detachment and neovascular glaucoma.
2. **Increased Vascular Permeability**: Leakage of fluid from blood vessels, causing macular edema, which is a swelling of the macula and the main cause of vision loss in diabetics.
**Symptoms and Diagnosis
Diabetic retinopathy often has no symptoms in the early stages. It is therefore crucial for diabetics to have regular eye examinations. Examinations include:
- Fundoscopy**: An examination of the fundus of the eye to detect changes in the retina.
- Retinography**: Photography of the retina.
- Fluorescein angiography**: A test that uses fluorescent dye to visualize the blood vessels in the retina.
- OCT (Optical Coherence Tomography)**: A test that provides detailed images of the retina, especially useful for detecting macular edema.
*Stages of Diabetic Retinopathy*
Diabetic retinopathy is divided into stages:
1. **Mild Non-Proliferative Retinopathy**: Small microvascular aneurysms.
2. **Moderate Non-Proliferative Retinopathy**: More aneurysms and areas of capillary occlusion.
3. **Severe Non-Proliferative Rhetinopathy**: Extensive areas of capillary occlusion.
4. **Proliferative Retinopathy**: Growth of new abnormal vessels that can cause serious complications such as retinal detachment and vitreous hemorrhage.
**Treatment of Diabetic Retinopathy
Treatment depends on the stage of the disease. In the early stages, strict blood glucose control is crucial to prevent progression. In the more advanced stages, treatment options include:
- **Laser Photocoagulation**: Used to cauterize ischemic areas of the retina and prevent the growth of new abnormal vessels.
- Intravitreal injections**: Anti-angiogenic drugs, such as bevacizumab, are injected into the eye to reduce macular edema and neovascularization.
- Vitrectomy surgery**: Indicated in cases of severe vitreous hemorrhage or retinal detachment, where the vitreous gel is removed and replaced with a saline solution.
**Prevention and the importance of regular check-ups
Prevention is the best medicine. Even without symptoms, people with diabetes should have regular eye examinations. Early diagnosis and appropriate treatment can prevent serious complications and preserve vision.
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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 for decision-making purposes, which requires a face-to-face consultation with a specialist doctor.
Author:
Dr. Mário César Bulla
Cremers 28120
Ophthalmologist - Retinologist
www.clinicabulla.com.br
www.especialistaemretina.com.br
Instagram: @retina.bulla
Video URL: • O que é a retinopatia...
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0:00 Diabetic retinopathy - what is it?
0:35 Diabetic retinopathy: the main cause of blindness.
1:15 Type 1 and type 2 diabetes: how are they affected?
3:00 Why does diabetic retinopathy happen?
3:45 Macular edema
4:10 The stages of diabetic retinopathy.
4:30 How is diabetic retinopathy detected?