Changes in the fundus in diabetes
Endocrinology / / May 14, 2016
prevalence of diabetes around the globe is large and also has a tendency to increase.The problem with this disease currently requires a deep and comprehensive study.
diabetes - a chronic disease in which primarily affects the small blood vessels (arterioles, venules and) various organs and systems.Because of its anatomical structure of the body at the same time are more likely to suffer as a result of hemodynamic characteristic changes with venous primarily venules, forming an aneurysm, degenerative changes and the fat, followed by worsening of the pathological changes in the retina and the involvement of the process and other elements of the eyeball.
Changes organ of vision, resulting in diabetes, diverse both in localization and in defeat gravity.To a greater or lesser extent, affected all departments eyes.The pathological process is usually bilateral.Body of the complications of diabetes on the basis of the most severe and is threatening diabetic retinopathy.
stages of diabetic changes in the fund
Among the many diabetic fundus changes in classifications in our country is increasing recognition of the classification proposed in M. Krasnov, G. and M. Margolis.According to her, these changes consist of three stages;the growth stage corresponds to the weighting of changes in the pathological process.
I stage - diabetic angiopathy - is characterized by changes in venous vessels of the retina.Recently expanded, have an uneven caliber, tortuous;there is a significant number of microaneurysms.It is emphasized that, according to the literature, stage I disease vascular changes in a limb 80% correspond to changes in retinal vessels.This symptom will definitely be considered when making a diagnosis of diabetes.Under these pathological changes in visual functions remain high.Employability of patients saved.
II stage - simple diabetic retinopathy.In this stage of the disease changes occur in the structure of the retina itself.Therefore, along with the changes corresponding stage I disease, hemorrhage observed, and the point in the form of spots, which are located in the inner layers of the retina, mainly in the central parts of the fundus.Sometimes there preretinal and hemorrhage.There are sections haze of the retina in the macular localization, premakulyarnoy areas and around the optic disc.They have a kind of yellowish-white, crisp, brilliant centers of the so-called dry exudates.There is also often observed salt encrustation.Retinal artery and optic disc in this step is usually not changed.Condition of visual function, and therefore, disabled patient is entirely dependent on the location, depth and extent of the pathological changes in the eye.
III stage - proliferative diabetic retinopathy.It characterized by the presence of all these changes, which are joined gross destructive changes in the fundus and in other parts of the posterior segment of the eye.There have been more extensive and multiple hemorrhages, often preretinal, and vitreous.There is a mass of newly formed blood vessels and proliferative changes in the retina tissue, which are the cause of severe complications, such as retinal detachment, retinal tear and others.
for diabetes change the optic nerve is not typical, but in stage III diabetic changes in the fundus sometimesmarked pallor and slight swelling of the disc material.These changes can be attributed to malnutrition last and sclerotic changes in the arterial system.Proliferative diabetic retinopathy is more common in severe forms of diabetes.
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Complications of eye atdiabetes
Among the serious complications of the body, leading to a weakening of visual functions, the main one is diabetic cataract.According to the literature, patients with diabetes, predisposition to the development of cataracts occur 6-8 times more often than those without this disease.A characteristic feature of diabetic cataract is a bilateral disease, the rapid development of it, sometimes for days or even hours, a rapid change in refraction of the eye.An early sign of diabetic cataracts is to develop subcapsular vacuoles beneath the posterior capsule of the lens.Then it starts clouding, which is moving from the periphery to the center.Sometimes diabetic cataract has a star-shaped appearance.
Such changes of the iris as diabetic iritis and iridocyclitis are complications of diabetes toksikoallergicheskih nature.They develop as a result of sensitization of the anterior vascular tract and manifest themselves in severe rear leaf iris pigment degradation.final structure becomes rough, adhesions develop in front of the root.One of the manifestations of diabetes are newly formed blood vessels of the iris, which appear as a result of hypoxia its fabric.The consequence of these lesions is a secondary glaucoma.It appeared in the corner of the front of the camera, new anatomical structures close and deform the lumen of Schlemm's canal, disrupting the circulation of intraocular fluid.
quite common complication of diabetes - recurrent vitreous hemorrhage.They tend to be extensive and will lead to a sharp decrease in visual functions.As the resorption of hemorrhages visual functions are restored.The threat of blindness occurs when there is a process of organization and proliferation of blood streamed having irreversible.
In the structure of the causes of blindness and low vision effects of diabetes complications occupy one of the first places.Drastic reduction of disability results in lower patient until its complete loss.Given the severity of organ complications of diabetes, it is necessary to pay more attention to the complaints of patients.Evaluation of patients with diabetes mellitus by an ophthalmologist should be done 2 times a year.