Retinopathy is a lesion of some origin to the retina of the eyeball. The main cause for this is vascular disorders that contribute to a disorder in the supply of blood to retina. Retinopathy also occurs as a complication of hypertension, diabetes mellitus and other systemic conditions. Speaking of a non-inflammatory origin is not entirely right, because at least diabetic retinopathy is followed by an inflammatory response to the deep glycation end products. Retinopathy development leads to disability, or vision loss.
Diabetic retinopathy
Diabetic retinopathy is a vascular disease, as a complication of diabetes. Diabetes mellitus is a metabolic disease that is becoming more common in our society, which damages the small blood vessels of the retina due to the metabolic decompensation that it causes. The retina is a thin layer of photosensitive tissue that lines the back of the eye. This is an element on which light rays are focused and transmitted to the brain for their interpretation as an image. Damage to this tissue causes loss of vision, which can be very significant and irreversible.
Depending on the type and degree of typical signs of diabetic retinopathy (DR), such as microaneurysms, microbleeds, microinfacts, lipid exudative foci, neovascularization, etc., the disease is classified into several stages: initial, moderate, severe and proliferative.
With all forms of diabetic retinopathy, diabetic retinal edema in the macular zone (DOM) can occur, which is the main reason for the decrease in visual acuity in diabetes.
Diabetic macular edema is the accumulation of fluid in the macula, the central and most sensitive region of the retina, which is responsible for good visual acuity.
Hypertensive retinopathy
Hypertensive retinopathy is damage that arterial hypertension does to the retinal vessels. Symptoms typically manifest in the later stages of the illness. Ophthalmoscopy visualizes spasms of the fundus arterioles, irregular arteriovenous crosses, changes in blood vessel walls, flammable hemorrhages in the fundus, cotton-like foci, yellow rigid exudates and swelling of the optic nerve head. The treatment consists of regulating the blood pressure and local vision reduction therapy.
A sharp rise in blood pressure (BP) leads to a reversible spasm of the retinal vessels; hypertensive crisis can cause swelling of the optic disc. Longer and more pronounced episodes of blood pressure rise provoke an exudative reaction from the retinal vessels, thereby leading to damage to the endothelium and the development of necrosis. Other changes (for example, thickening of the walls of the arterioles, pathological arteriovenous cross) develop after many years of high blood pressure. Smoking exacerbates the manifestations of hypertensive retinopathy.
Arterial hypertension also reflects a major risk factor for certain forms of retinal lesions (e.g., occlusion of retina arteries or veins, diabetic retinopathy). The combination of arterial hypertension and diabetes significantly raises the risk of loss of vision. Additionally, the risk of vascular damage to other internal organs is increased in patients with hypertensive retinopathy.
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