原创力文档Diabetic Retinopathy - Home page wwwdiabeticretinopathy ：糖尿病视网膜病变wwwdiabeticretinopathy -首页.ppt
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Diabetic Retinopathy - Home page wwwdiabeticretinopathy ：糖尿病视网膜病变wwwdiabeticretinopathy -首页
Diabetic Retinopathy Epidemiology ( The World Health Organisation (1992) definition of blindness is vision less than 3/60 in the better eye with best available spectacle correction. ) ? Diabetes is therefore one of the most serious challenges to health care world-wide. According to recent projections it will affect 239 million people by 2010- doubling in prevalence since 1994. Diabetes will affect 28 million in western Europe, 18.9 million in North America 138.2 million in Asia, 1.3 million in Australasia. ? Diabetes mellitus is the most common cause of blindness amongst individuals of working-age ( 20-65 years). The prevalence of blindness due to DR in Western Communities is estimated as between 1.6-1.9/ 100,000 Presentation About 2% of type 2 diabetics have CSME at diagnosis and 10.2% have other signs of DR already present when their diabetes is discovered. Mitchell and co- workers found that 15.8 % of undiagnosed diabetics in an elderly Australian population had signs of DR, according to the recent Blue Mountains Eye Study. Indeed it may often take from 9-12 years for type 2 diabetes to be diagnosed A classification of diabetic retinopathy ? A useful classification according to the types of lesions detected on fundoscopy is as follows: ? Non-proliferative diabetic retinopathy (NPDR) ? Mild non-proliferative diabetic retinopathy Microaneurysms Dot and blot haemorrhages Hard ( intra-retinal ) exudates ? Moderate-to-severe non-proliferative diabetic retinopathy ? The above lesions, usually with exacerbation, plus: Cotton-wool spots Venous beading and loops Intraretinal microvascular abnormalities ( IRMA ) ? Proliferative diabetic retinopathy ? Neovascularization of the retina, optic disc or iris Fibrous tissue adherent to vitreous face of retina Retinal detachment Vitreous haemorrhage Pre retinal haemorrhage ? Maculopathy Clinically significant macular oedema (CSME ) Ischaemic Maculopathy Pathogenesis of Diabetic Microangiopathy ? Hyperglycaemia cause
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