Diabetic retinopathy (commonly known as “sugar net”) and diabetic macular edema are the leading cause of blindness in diabetic patients and the most worrying eye complication for diabetic patients. Among every 10 diabetics in our country, 4 may be complicated by diabetic retinopathy, which has become the first blinding eye disease in adults, with huge lethality. Professor Ma Jin, chief physician of the Fundus Disease Center of the Zhongshan Ophthalmic Center of Sun Yat-sen University, pointed out that the number of patients with sugar nets found in clinical practice is increasing year by year, accounting for almost half of the fundus disease clinics of the eye hospital. Visual function damage caused by diabetes is irreversible. Early ophthalmological screening, diagnosis and timely treatment should be paid attention to, which can avoid blindness to the greatest extent, grasp the timing of precise treatment, and save current vision.
Trend: The incidence can be as high as 60% of patients are unaware
Ma Jin introduced that there are many ocular complications caused by diabetes, including cataracts, eye nerve problems and retinal disease, etc. When retinal blood vessels are exposed to a high sugar environment for a long time, they will become fragile, like cracked water pipes, easy to leak and bleed. Diabetic retinopathy (especially diabetic macular edema) is the leading cause of blindness in diabetics, and it is also the leading cause of blindness in people of working age. The leading cause of blindness in the population.
“According to the international classification standard, patients with stage I sugar net include those who have diabetes but do not actually develop retinopathy, which is called ‘stage I change of diabetic retinopathy’. If this part of the population is included in the , the incidence of sugar net can be as high as more than 60%.” Ma Jin said. In the incidence rate as high as 60%, a considerable part of the patients with Glycine will stay in the first to third stage of the disease for life, no intraretinal neovascular proliferation occurs, and almost no obvious symptoms are revealed, so they are not diagnosed. “From the perspective of clinical treatment, The incidence rate is much lower, and the eventual blindness is expected to be around 10% to 20%.”
Characteristics: “erratic” personality, disease progression can be “jumped”
Although for some” “Lucky”, you can stay in the first to third stage of sugar net for life, which has little impact on life. However, for most diabetic patients, sugar net is the primary cause of blindness in diabetic patients. Once it starts, even if blood sugar is controlled Well, the lesion will continue to develop, it will not stop, and unlike cataracts, once the optic nerve is damaged, the process is irreversible.
Compared with blinding eye diseases such as glaucoma and macular degeneration, Tangwang is a very “erratic” eye disease. “It’s development process is not gradual according to steps, but will develop suddenly ‘jumping’, for example, some patients can quickly transition from stage 3 to stage 5, or even the most serious stage 6, which needs to be implemented immediately. Surgery is a race against time to save vision.” Ma Jin said that in clinical practice, it was found that a considerable number of patients did not have a deep understanding of the “erratic nature” of this disease, and always thought that they could wait, or found blurred vision or even one eye. Seeing a doctor when you can’t see it, or abandoning the ophthalmologist’s recommendation to only take conservative medical treatment, you miss the best time for treatment. ”
Prevention and control: early screening for lifelong follow-up
For this blinding eye disease with an “erratic” character, Ma Jin reminded that once diagnosed with diabetes, ophthalmology should be started as soon as possible. Screening. On the one hand, if eye lesions have not yet occurred, early screening can leave an initial eye image record. This record is quite precious for doctors and patients, and can be compared and referenced to capture later disease progression. On the other hand, the early signals of sugar net can be captured as soon as possible, because the early symptoms of sugar net patients are not obvious, and the disease can be better controlled through early screening and early treatment. For patients diagnosed after screening, Ma Jin said that a personal file for life-long follow-up should be established, follow the doctor’s orders according to personal conditions, and regularly go to the eye hospital for physical examinations to intercept the signs of disease development and further lesions in time.
According to experts, if it is a common type 2 diabetes patient without other systemic diseases, in principle, the fundus can be reviewed once a year. For patients with high-risk factors, such as diabetes accompanied by hypertension, abnormal renal function, etc., the follow-up time should be shortened accordingly. It is worth noting that hypertension, hyperlipidemia, renal impairment, immune diseases such as systemic lupus erythematosus, and advanced pregnancy are all high-risk factors, and the follow-up time should be shortened. If the sugar net is between three and four stages, which is a progressive stage, it may be more necessary to follow up once a month.
At present, there are three main treatment methods for sugar net: laser, intraocular injection and vitrectomy. According to the severity of the patient’s condition, the doctor will use one or a combination of treatment methods to formulate a personalized treatment plan. The goal is to control the development of the disease and preserve useful life vision. (Tai Mengyun and Wei Chunfu, correspondents of all media reporter Liang Chaoyi)