Thursday, October 26, 2006

Diabetes: Diabetic Retinopathy

Diabetic retinopathy is one of the complications of diabetes. In diabetic retinopathy, the retinas of the eyes become damaged as a result of prolonged high levels of blood glucose.

"Diabetic retinopathy is the most frequent cause of new cases of blindness among adults aged 20 - 74 years. During the first two decades of disease, nearly all patients with type 1 diabetes and [greater than] 60% of patients with type 2 diabetes have retinopathy. In the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR), 3.6% of younger-onset patients (type 1 diabetes) and 1.6% of older-onset patients (type 2 diabetes) were legally blind. In the younger-onset group, 86% of blindness was attributable to diabetic retinopathy. In the older-onset group, in which other eye diseases were common, one-third of the cases of legal blindness were due to diabetic retinopathy.

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"Vision-threatening retinopathy is rare in type 1 diabetic patients in the first 3 - 5 years of diabetes or before puberty. During the next two decades, nearly all type 1 diabetic patients develop retinopathy. Up to 21% of patients with type 2 diabetes have retinopathy at the time of first diagnosis of diabetes, and most develop some degree of retinopathy over time. Vision loss due to diabetic retinopathy results from several mechanisms. Central vision may be impaired by macular edema or capillary nonperfusion. New blood vessels of PDR and contraction of the accompanying fibrous tissue can distort the retina and lead to tractional retinal detachment, producing severe and often irreversible vision loss."
Source: Fong and others, "Retinopathy in Diabetes," Diabetes Care 27:S84-S87, 2004, see: http://care.diabetesjournals.org/cgi/content/extract/27/suppl_1/s84

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diabetic retinopathy