Diabetes, during its course, can cause a long series of chronic complications.

Diabetic retinopathy is one of the most serious. This, if not properly followed, can lead to a severe reduction of visual capacity, which can lead, in the most serious cases, in blindness. In fact, the Diabetic Retinopathy and Age-Related Macular Degeneration share the dubious distinction of the main causes of blindness acquired among adults in Western countries.

The duration of diabetes and poor glycemic control are essential both for the ‘onset of diabetic retinopathy for the rapidity of its evolution, it is therefore implied that glycemic control is critical to delay the onset of retinopathy or slowing worsening.

It is essential then periodically check the fundus, to promptly identify any initial retinal damage.

NORMAL FUNDUS

Diabetic retinopathy is classified into two forms:

• Do not proliferating, earlier and less severe, in slight variants, moderate or advanced
• Proliferating

NONPROLIFERATIVE DR

  

SEIOUS NONPROLIFERIVTE DR

PROLIFERATIVE DR

The nonproliferative if not promptly diagnosed and treated according to protocol, can evolve in the proliferative form that is highly disabling.

In diabetes the retina is damaged because hyperglycemia alters the structure of the retinal vessels by inducing the formation of microaneurysms and haemorrhages, as well as causing alterations of retinal vascular caliber.

All of these phenomena can lead to two main consequences:

• The passage of some blood components, through the walls of damaged vessels with edematous phenomena and exudative
• The reduced perfusion of the retinal tissue until you get to a complete ischemia

The formation of ischemic retinal areas constitute the stimulus for the formation of retinal neovascularization, which characterize the proliferating form. These new blood vessels have a less robust than normal and are prone to rupture, resulting in bleeding and endovitreal pre-retinal and sub-retinal detachments.