糖尿病性视网膜病变
专家:
什么是糖尿病视网膜病变?
Diabetic retinopathy is a condition that occurs when diabetes affects the blood vessels and nerve tissue in the retina.
糖尿病视网膜病变分为两个阶段:
- Nonproliferative视网膜病变 is the early stage of the disease in which blood vessels swell and leak. 在某些情况下, this can cause macular edema (swelling of the retina) which may result in mild vision loss but can be treated. There can also be early changes to the nerve cells in the retina that may affect vision, 部分原因是由于血液供应不足.
- 增生性视网膜病变 is the advanced stage where abnormal new blood vessels grow on the surface of the retina. 这些血管可能破裂并出血进入玻璃体, 充满眼睛的透明水状凝胶, 并导致严重的视力丧失. This stage of diabetic retinopathy typically requires urgent treatment.
While diabetic retinopathy often cannot be completely prevented, you can reduce your risk of having it develop or progress. Controlling your blood sugar slows the start of retinopathy and prevents it from getting worse. It also lessens the need for laser surgery or other procedures that treat severe retinopathy.
糖尿病视网膜病变的原因?
Diabetic retinopathy is caused by changes in the blood vessels of the retina, the light-sensitive layer of tissue at the back of the inner eye. In some people with diabetic retinopathy, the blood vessels in the retina may swell and leak fluid. In others, abnormal new blood vessels grow on the surface of the retina. 这些变化可能导致严重的视力丧失.谁有患糖尿病视网膜病变的风险?
Anyone with diabetes is at risk for diabetic retinopathy. The longer you have diabetes, the more likely you are to develop diabetic retinopathy. Your risk rises if you have diabetes and you also smoke, have high blood pressure, or are pregnant.糖尿病视网膜病变的症状是什么?
在糖尿病视网膜病变的早期, you may have no symptoms and your vision may not change until the disease gets worse. 当疾病进展时, 你可能会有模糊或重影, 黑斑或浮斑, 单眼或双眼疼痛或受压, 环, 闪烁的灯光, 或者你视野中的空白点.
A condition called macular edema may occur from diabetic retinopathy. 黄斑水肿发生在黄斑, 视网膜的中心部分, 因液体泄漏而肿胀，导致视力模糊. 当新的血管在视网膜表面生长时, they can bleed into the eye and lead to a decrease in vision as well.
如何诊断糖尿病视网膜病变?
你的眼科医生可能会做以下检查, 还有完整的健康史和眼科检查, 诊断糖尿病视网膜病变:
- 视力测验. The common eye chart test that measures central vision ability at various distances.
- 张力测定法. A standard test that checks the pressure (intraocular pressure, or IOP) inside the eye.
- 瞳孔放大. An examination where your pupil is widened with eye drops for a close-up of the eye’s lens and retina.
- 检眼镜检查. An examination where your doctor looks very closely at the retina using a special magnifying glass.
- 荧光素血管造影. A test where an organic dye is injected into the bloodstream to show the blood vessels in the eye. This occurs while pictures are taken with a special camera and will show your doctor if the blood vessels are leaking or no longer supplying areas of retina.
- 光学相干层析成像. A test where light waves are used to make detailed images of the retina.
如何治疗糖尿病视网膜病变?
Treatment for diabetic retinopathy will depend on your symptoms, age and general health. 这也取决于病情的严重程度.
People with advanced retinopathy have a good chance of keeping their vision if they are treated before the retina becomes severely damaged. Treatment for diabetic retinopathy may include one or a combination of the following:
- 激光手术. This is often used to treat proliferative retinopathy and sometimes macular edema. It involves shrinking the abnormal blood vessels, or sealing the leaking ones.
- 玻璃体切除术. 玻璃体切除术 is a procedure that involves removing the jelly-like substance (vitreous) that fills the center of the eye. The vitreous is replaced with a balanced saline solution.
- 注射. Certain medications can be injected into the eye to slow the growth of the abnormal vessels of the retina and to treat macular edema.
糖尿病视网膜病变可以预防吗?
Although it can be challenging to prevent diabetic retinopathy, there are steps you can take to reduce the risk of it developing or progressing.
每年做一次糖尿病眼科检查
An eye exam can help diagnose eye problems for treatment and can alert you and your health care provider if your diabetes needs to be better controlled. Women with diabetes should have an eye exam before pregnancy or in the first trimester. Continue to be monitored every trimester and for one year after birth depending on the severity of the retinopathy.
遵循你的糖尿病管理计划
The following steps should be taken to maximize your treatment:
- 按医嘱服药.
- 如有需要，按指示使用胰岛素.
- Eat a healthy and balanced diet to manage blood sugar level.
- 通过运动来降低和帮助身体使用血糖.
- 定期检测血糖水平.
- 定期检测血红蛋白A1c水平.
- 定期检查尿液中的酮水平.
- Have regular health care follow-ups to evaluate diabetes control and rule out or treat other risk factors, 比如高血压.
Better control of blood sugar slows the onset and progression of retinopathy and lessens the need for laser surgery or other procedures for treating severe retinopathy.
