KNOWING DIABETIC RETINIS
Diabetic retinitis is a sugar diabetis complication, resulting from retina vessel damage which compromises the visual prognosis.
-Today, diabetic retinitis is a major cause of eyesight loss. In the elderly, it is the 4th cause of ocular damage after cataract, glaucoma and age-related macular degeneration. It is even the first cause of blindness for people under 50 in the industrialized countries.
– Diabetic retinitis appears on average after 15 years of diabetis evolution. It is all the mor frequent when diabetis is poorly balanced because sugar excess in the blood can damage tiny vessels in the eyes.
– Diabetic retinitis can be divided into two categories depending on the disease stage: non-proliferating (early stage) and proliferating (advanced stage).
- Non-proliferating diabetic retinitis: it is the most common form of diabetic retinitis and corresponds to a light to moderate impairment. Most of the time the fundoscopy reveals signs of retinal ischemia.
- Proliferating diabetic retinitis: occurs when the retinal ischemia is more severe. Presence of neovessels, retinal bleeding, retinal detachment are the most common signs, with a risk of eyesight loss.
TREATING DIABETIC RETINITIS
Diagnosis
Only an ophtalmologist can diagnose diabetic retinitis.
A visual acuity test followed by a fundoscopy are necessary to make a diagnosis.
Other examinations such as optic coherence or angiography can help to refine the diagnosis.
Treatment
Close control of sugar levels and blood pressure as prevention is the first treatment for diabetic retinitis.
In the stage of proliferating diabetic retinitis, various treatments can be implemented depending on the disease stage and the possible complications.
Au stade de rétinopathie diabétique proliférante, différents types de traitement pourront être proposés en fonction du stade évolutif et de la présence ou non de complications :
- laser panretinal photocoagulation: specific treatment for proliferating diabetic retinitis.
- surgical vitreous vitrectomy: for vitreous body bleeding and proliferating diabetic retinitis treatment.
- intra-vitreous corticoid injection: leads to significant improvement of the macular oedema and visual acuity.
- anti-angiogenic treatment by intra-vitreous injection: reduces retinal neovascularization.
CONCLUSION
Blindness caused by diabetic retinitis is now widely avoidable thanks to early detection and appropriate interventional treatment.
It is very important to implement systematic screening, throughout life.
Considering that sugar diabetis is a systemic disease, optimal treatment requires a multidisciplinary approach: diabetologist, dietician, general practitioner…