Diabetic retinopathy pathophysiology: Difference between revisions
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{{Diabetes mellitus}} | {{Diabetes mellitus}} | ||
{{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh@perfuse.org] | {{CMG}}; '''Associate Editor(s)-In-Chief:''' [[Priyamvada Singh|Priyamvada Singh, M.B.B.S.]] [mailto:psingh@perfuse.org] | ||
==Overview== | ==Overview== | ||
Diabetic retinopathy is the result of [[microvascular]] abnormalities of the retina. | |||
Diabetic retinopathy is result of microvascular | |||
==Pathophysiology== | |||
[[Hyperglycemia]]-induced [[pericyte]] death and thickening of the [[basement membrane]] lead to incompetence of the vascular walls. These damages change the formation of the [[blood-retinal barrier]] and also make retinal blood vessel become more permeable.<ref>Understanding diabetic retinopathy by Pardianto G et al., in Mimbar Ilmiah Oftalmologi Indonesia.2005;2: 65-6.</ref> | |||
===Nonproliferative Diabetic Retinopathy (NPDR)=== | |||
Small [[blood vessel]]s – such as those in the eye – are especially vulnerable to poor [[blood sugar]] control. An overaccumulation of [[glucose]] and/or [[fructose]] damages the tiny blood vessels in the retina. During the initial stage, called nonproliferative diabetic retinopathy (NPDR), most people do not notice any changes in their vision. | Small [[blood vessel]]s – such as those in the eye – are especially vulnerable to poor [[blood sugar]] control. An overaccumulation of [[glucose]] and/or [[fructose]] damages the tiny blood vessels in the retina. During the initial stage, called nonproliferative diabetic retinopathy (NPDR), most people do not notice any changes in their vision. | ||
===Macular Edema=== | |||
Some people develop a condition called [[macular edema]]. It occurs when the damaged blood vessels leak fluid and [[lipid]]s onto the [[macula]], the part of the retina that lets us see detail. The fluid makes the macula swell, which blurs vision. | Some people develop a condition called [[macular edema]]. It occurs when the damaged blood vessels leak fluid and [[lipid]]s onto the [[macula]], the part of the retina that lets us see detail. The fluid makes the macula swell, which blurs vision. | ||
As the disease progresses, severe nonproliferative diabetic retinopathy enters an advanced, or proliferative, stage. The lack of [[oxygen]] in the retina causes fragile, new, blood vessels to grow along the retina and in the clear, gel-like [[vitreous humour]] that fills the inside of the eye. Without timely treatment, these new blood vessels can bleed, cloud vision, and destroy the retina. Fibrovascular proliferation can also cause tractional retinal detachment. The new blood vessels can also grow into the angle of the anterior chamber of the eye and cause Neovascular Glaucoma. Nonproliferative diabetic retinopathy shows up as cotton wool spots, or microvascular abnormalities or as superficial retinal hemorrhages. Even so, the advanced proliferative diabetic retinopathy (PDR) can remain [[asymptomatic]] for a very long time, and so should be monitored closely with regular checkups. | ===Proliferative Diabetic Retinopathy=== | ||
As the disease progresses, severe nonproliferative diabetic retinopathy enters an advanced, or proliferative, stage. The lack of [[oxygen]] in the retina causes fragile, new, blood vessels to grow along the retina and in the clear, gel-like [[vitreous humour]] that fills the inside of the eye. Without timely treatment, these new blood vessels can bleed, cloud vision, and destroy the [[retina]]. Fibrovascular proliferation can also cause tractional [[retinal detachment]]. The new blood vessels can also grow into the angle of the anterior chamber of the eye and cause [[Neovascular Glaucoma]]. Nonproliferative diabetic retinopathy shows up as [[cotton wool spots]], or microvascular abnormalities or as superficial [[retinal hemorrhages]]. Even so, the advanced proliferative diabetic retinopathy (PDR) can remain [[asymptomatic]] for a very long time, and so should be monitored closely with regular checkups. | |||
==External links== | ==External links== | ||
*[http://www.nei.nih.gov/health/diabetic/retinopathy.asp Diabetic Retinopathy] Resource Guide from the National Eye Institute (NEI). | *[http://www.nei.nih.gov/health/diabetic/retinopathy.asp Diabetic Retinopathy] Resource Guide from the National Eye Institute (NEI). | ||
*[http://diabetes.niddk.nih.gov/ National Diabetes Information Clearinghouse] | *[http://diabetes.niddk.nih.gov/ National Diabetes Information Clearinghouse] | ||
{{Endocrine pathology}} | {{Endocrine pathology}} | ||
Revision as of 14:58, 17 September 2011
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Priyamvada Singh, M.B.B.S. [2]
Overview
Diabetic retinopathy is the result of microvascular abnormalities of the retina.
Pathophysiology
Hyperglycemia-induced pericyte death and thickening of the basement membrane lead to incompetence of the vascular walls. These damages change the formation of the blood-retinal barrier and also make retinal blood vessel become more permeable.[1]
Nonproliferative Diabetic Retinopathy (NPDR)
Small blood vessels – such as those in the eye – are especially vulnerable to poor blood sugar control. An overaccumulation of glucose and/or fructose damages the tiny blood vessels in the retina. During the initial stage, called nonproliferative diabetic retinopathy (NPDR), most people do not notice any changes in their vision.
Macular Edema
Some people develop a condition called macular edema. It occurs when the damaged blood vessels leak fluid and lipids onto the macula, the part of the retina that lets us see detail. The fluid makes the macula swell, which blurs vision.
Proliferative Diabetic Retinopathy
As the disease progresses, severe nonproliferative diabetic retinopathy enters an advanced, or proliferative, stage. The lack of oxygen in the retina causes fragile, new, blood vessels to grow along the retina and in the clear, gel-like vitreous humour that fills the inside of the eye. Without timely treatment, these new blood vessels can bleed, cloud vision, and destroy the retina. Fibrovascular proliferation can also cause tractional retinal detachment. The new blood vessels can also grow into the angle of the anterior chamber of the eye and cause Neovascular Glaucoma. Nonproliferative diabetic retinopathy shows up as cotton wool spots, or microvascular abnormalities or as superficial retinal hemorrhages. Even so, the advanced proliferative diabetic retinopathy (PDR) can remain asymptomatic for a very long time, and so should be monitored closely with regular checkups.
External links
- Diabetic Retinopathy Resource Guide from the National Eye Institute (NEI).
- National Diabetes Information Clearinghouse
cs:Diabetická retinopatie
de:Diabetische Retinopathie
nl:Diabetische retinopathie
fi:Diabeettinen retinopatia
- ↑ Understanding diabetic retinopathy by Pardianto G et al., in Mimbar Ilmiah Oftalmologi Indonesia.2005;2: 65-6.