Editorial - Journal of Clinical Ophthalmology (2020) Volume 4, Issue 2
Diabetic Retinopathy: An emerging ocular disorderShamim Ahmad*
Aligarh Muslim University, Aligarh, India
- Corresponding Author:
- Shamim Ahmad
Aligarh Muslim University
Accepted date: June 15, 2020
Diabetic retinopathy in diabetic patients ranging in age between 21 and 70 years is a major cause of visible impairment and blindness. It leads to changes in the retinal system that occurs due to hyperglycemia resulting in catastrophic complications unless controlled early. Lamentably, due to a lack of symptoms in the early stages, the majority of patients arrive late. Owing to the delayed onset of symptoms and the rapid development of retinopathy, several screening methods are used to enhance symptoms and postpone development to detect early retinal changes.
To minimize morbidity associated with diabetic retinopathy and diabetic macular edema, various preventive and therapeutic approaches have been used. Managing diabetic retinopathy depends on the degree, severity, and presence or absence of macular diabetic edema. Diabetes mellitus affects about 463 million adults worldwide, a figure that is projected to grow by 2030 to 592 million. Diabetic eye disease is a category of ocular problems that affect patients with DM. It consists of retinopathy for diabetics (DR), diabetic maculopathy, cataract, and glaucoma. Despite DR's preventable existence, it is a leading cause of blindness in adults aged between 20 and 74.
An analysis by Bourne et al in 2017 found that approximately 2.2 billion people suffered from visual impairment or blindness, and at least half of them had a visual impairment that was preventable or unaddressed. DR is the 5th most common cause of visual loss at mild to extreme distance and preventable blindness following refractive error, cataract, glaucoma, and corneal opacities. According to the findings of the review of 35 studies performed worldwide between 1980 and 2008, the total incidence of DR in retinal imaging patients with visionthreatening DR was nearly 40%. DR prevalence of type 1 and type 2diabetes has been influenced by diabetes length, excessive hyperglycemia, and higher blood pressure. DR was more prevalent in patients with type 1 diabetes, although variations between African Americans (55.7 percent), Caucasians (44.7 percent), and Asians (20.8 percent) were apparent in type 2 diabetes. This did not include data from lowand middle-income countries in which the prevalence of range vision impairment is approximated to be four times higher than high-income territories due to the high diabetes impact and poor accessibility to DR screening and management. In 2015, Thomas et al performed an analysis of 32 studies from 2015 to 2018 to assess global prevalence.
The findings showed that DR's average global prevalence was 27%. Differences between regions were noted with the increasing incidence in Africa, the Middle East and North Africa (34%), followed by the Western Pacific region (36%), Europe (21%) and South-East Asia (13%) respectively. The macular edema, hemorrhage from fragile new arteries, neovascular glaucoma, or retinal detachment may cause vision loss or disability in DR. DR is the product of interactions between several genes and environmental influences, particularly high blood sugar levels, which is the primary adjustable factor for risk.
Excessive permeability of the retinal capillaries, vascular occlusion, proliferation of fragile new vessels, and contraction of fibro vascular membranes are the main factors involved in DR pathogenesis. The period and severity of hyperglycemia are the main risk factors for retinopathy development. Hyperglycaemia, pregnancy, and hypertension increase the flow of retinal blood, resulting in the development of micro aneurysms in capillaries, precapillary arterioles, and venules leading to congestion of these tiny vessels and fluid and lipid transmutation in the retina. Type 1 diabetes patients will undergo a thorough dilated eye test by a specialist within 5 years of diagnosis. Patients with type 2 diabetes will undergo a thorough dilated eye test by a specialist simultaneously. When no proof of retinopathy is found along with well-controlled hyperglycemia for one or more annual dilated eye tests, then screening is deemed every 12-24 months. If any form of diabetic retinopathy is identified it can require an annual or more regular.
Delayed diagnosis or retinopathy treatment can lead to serious complications with high morbidity levels. Therefore, health care professionals and diabetic patients should be aware of the importance of making qualified ophthalmologists test for diabetic retinopathy. Uncontrolled hyperglycemia, obesity, dyslipidemia, and pregnancy are considered risk factors for rapid diabetic retinopathy development in patients with diabetes. For patients with these conditions, screening and counselling are also necessary.