Retinopathy Overview

摘要

Q: Many of my patients with diabetes are concerned about blindness as a complication. What can ! share with them? Retinopathy is the primary cause of blindness in working adults and the most frequent microvas-cular complication in diabetes. This complication is strongly related to the duration of diabetes. Poor glucose control and hypertension also contribute to this risk. Other risk factors include gender (male), diabetic nephrop-athy, puberty, smoking, and dys-lipidemia and pregnancy. It is important to note that the presence of retinopathy doubles the risk of cardiovascular disease. Early identification can delay progression, and because there are no symptoms in the early stages, screening by an ophthalmologist or optometrist familiar with retinopathy is recommended. Patients with type 1 diabetes mellitus (DM) should have an initial dilated eye exam 5 years after diagnosis. Patients with type 2 DM should be examined at diagnosis. Pregnant women should have an exam in the first trimester, and be followed closely throughout pregnancy and through the first year postpartum. Eye exams can be considered every 2 years if there has been no evidence of retinopathy, annually if retinopathy is present and more frequently if it is progressing or sight is threatened. Retinal photography with remote reading by experts can be cost effective.