Diabetic Retinopathy

Diabetic Retinopathy

Diabetic Retinopathy is the more frequent cause of blindness between the 30 and 64 years in Inglaterra and Gales. This kind of blindness can be prevented and is labour of the doctor to carry out an ophtalmological exam per year for all the patients with diabetes mellitus insulino dependent (DMID) with 5 years or more of evolution and since the moment of the diagnosis to all the diabetic no insulino dependent (DMNID). It is responsibility of the Sanitary Authorities offer the easiness needed to carry out this prevention.

 Normal  Diabetic Retinopathy

Chronological Age

The chronological age in the moment of the appearance of the diabetes mellitus (DM) and the duration of the same have a marked effect in the moment of the appearance of the retinopatía and after the 20 years of DM, almost all the patients show some kind of retinopatía. In the younger diabetic the middle interval between the diagnosis of DM and the development of retinopatía is 13 years, while in those that develop DM after 60 years, the interval is 5 years; in fact the 5 % of DMNID have a retinopathy established in the moment of the diagnosis.

Fortunately there can be a retinopathy of considerable grade without diminution of the visual sharpness and the prognosis can be optimist. However, in near of 15 %, the retinopatía is very light that if not treated it will appear an important diminution of the visual sharpness.
The patients need to be informed on the possibility of develop a diabetic retinopatía and the importance of the strict metabolic control for its prevention. They should inform about any new visual symptom. It is necessary to emphasizes the importance of the annual opthalmological revision.

Valoration of the Diabetic Retinopatia

Opthalmoscopia (exploration of the eye trough an equipment which emits a light that allows to observe the retina) annual, carried out with the dilated pupil.

Fluorescein angiography (this method consists in introducing a contrast that allows to see the route of the small arteries and veins which circulate trough the inner of the eye). This exploration is more sensible and allows to quantify the benefits of the treatment. Unsuccessful efforts have been made to predict the route of the diabetic retinopatía.

Risk Factors

The risk factor more important is the duration of the DM, above all for the proliferative retinopatía.

The metabolic control over the years also can be important and in general the prevalence of diabetic retinopatía in the diabetic population increases according to the categories good, middle and bad control.

However, some cases with good control develop a retinopatía very fast, while others with a bad control are free of this. Therefore, there can be other determinant factors, this factor can be genetic.