Diabetes complications can affect multiple organ systems throughout the body, and eye health in particular requires additional attention. Can diabetes have complications if blood sugar has been well controlled? Professor Meng Jing, chief physician of the Department of Ophthalmology of the First Affiliated Hospital of Jinan University, said that even if blood sugar is well controlled, it does not mean that diabetic retinopathy (DR) will not occur, but that the probability of occurrence will be reduced and the degree will be reduced, but with the course of diabetes Progress, the incidence of DR will continue to increase.
She suggested that middle-aged and elderly people over 50 years old should seek medical attention in time to check the cause and treat the symptoms if they find symptoms such as vision loss and visual distortion. Eyes are also very important.
1/3 diabetics will have retinopathy
Due to high blood sugar, diabetes will lead to retinal microcirculation disorder, and this small blood vessel damage will cause serious vision loss. Relevant statistics have found that about 1/3 of diabetic patients have DR, and about 1/3 of them will have diabetic macular edema (DME), which can seriously affect vision.
Nowadays, diabetic patients are getting younger and younger. Correspondingly, the age of the DR population is also getting younger. According to Meng Jing, clinical statistics show that the age of these patients is concentrated in the 40-60 years old. Young and middle-aged labor force, the time and scope of influence are wide.
“Many patients don’t care at first. For example, some patients may have a vision of 1.0 during a routine physical examination, but they may feel that things are blurred, like there is a film on their eyes, but they cannot be wiped off. If you don’t intervene immediately, the worst visual acuity can drop to 0.1.” Meng Jing emphasized that if you have blurred or deformed vision, you must seek medical attention in time and not delay. “Usually, for patients younger than 30 years old, we will ask him to check the fundus from the fifth year; if the patient is older than 30 years old, he should go to the ophthalmologist to check the fundus regularly as soon as the diagnosis is made.”
Good blood sugar control DR It also happens
Many patients feel that if their blood sugar is well controlled, is it not necessary to check their eyes regularly? In this regard, Meng Jing explained that even if blood sugar is well controlled, it does not mean that DR will not occur, but that the probability of occurrence will be reduced and the degree will be reduced. In fact, with the progress of diabetes, the incidence of DR is 25% in 5 years, 60% in 10 years, 80% in 15 years, and 100% will have different degrees of diabetic retinopathy in about 25 years.
Meng Jing explained that the macula is the area of the human eye with the sharpest vision, which senses photopic vision and color vision. Diabetic macular edema (DME) is caused by the breakdown of the blood-retinal barrier due to the long-term unstable state of blood sugar levels, and the accumulation of fluid (osmotic fluid) into the macula, causing macular edema. The occurrence of DME can cause severe vision loss, mainly in the central area of the visual field, there will be dark spots, that is, patchy blurred vision, and it is difficult to see details clearly, including near and far distances; contrast sensitivity will Descending, the color seen is dull and faded; seeing the shape of the object change, sometimes larger or smaller than the actual shape, the straight line appears wavy or broken in some parts of the field of view.
The prevention and treatment of DR should be carried out early
How to diagnose diabetic macular edema? Meng Jing introduced that the clinical examination of DME mainly includes slit lamp, fundus color photography, fundus fluorescein angiography (FFA), and optical coherence tomography (OCT).
In terms of treatment, Meng Jing introduced that before 2012, only the macular grid laser could be used to treat diabetic macular edema (DME). Although laser therapy can prevent the further progression of DME, it cannot restore or improve the vision of DME patients, and may lead to complications such as central scotoma and decreased vision. In recent years, local anti-VEGF injection has become the first-line treatment for DME recommended by domestic and foreign guidelines.
It should be reminded that there are many factors that affect the occurrence of DME in patients and lead to visual impairment. The rise and fluctuation of blood sugar, hypertension and hyperlipidemia are also important systemic factors. Lipid-lowering therapy has a significant effect on improving the process of DR and hard exudation. Therefore, the prevention and treatment of DR should be carried out at an early stage. In clinical practice, metabolic disorders should be actively improved in the early stage, and the intensive hypoglycemic, lipid-lowering, and hypotensive comprehensive treatment of DR should be standardized.
(All-media reporter Zhang Qingmei, correspondent Wang Xue and Zhang Cancheng)
[Editor in charge: Shen Tian]