DIABETIC RETINOPATHY

Abstract

Introduction: Diabetes mellitus or known as diabetes is a pathological, chronic, progressive and irreversible condition that attacks many organs in many different forms, hence it is called diabetic syndrome. It usually affects the vascular system leading to micro or macrovascular changes, the most common of which are: kidney (nephropatia diabetica), nervous system (neuropathia diabetica) and eye (retinopathia diabetica and cataracta diabetica). These changes that occur in the body as a consequence of diabetes mellitus depend on the degree of damage to the vascular system.

In the eye, as one of the most common organs affected by diabetes mellitus, metabolic disorders in diabetes can lead to various changes, for example: in the conjunctiva there are changes in the conjunctival blood vessels such as "aneurysmal enlargements", in the lens blurring that progresses relatively rapidly (cataracta diabetica) may occur. Damage and edema of the pigment cells also occur in the retinal pigment layer, but the most severe complication occurs in the fundus, approximately 12% of diabetics end in blindness, usually 8 to 15 years after the onset of diabetes, with neurovascular damage occurs that progresses before the first clinical signs of diabetic retinopathy appear. Around 240 million people worldwide suffer from this disease, and by 2030 it is expected to affect 370 million people. Disability in the United States and Europe is approximately 30% of the active population, while in the Republic of Northern Macedonia it is 19-24%, but this is certainly due to the low level of health education of our patients.Diabetic retinopathy is one of the most common microvascular complications of diabetes involving abnormal major retinal cell pathology, pigment epithelium, microaneurysms, papillary edema, bleeding, exudates, and intraocular neovascularization.

Although the exact cause of diabetic retinopathy is unknown, it is thought that in addition to the level of glucose in the blood, the duration of the disease plays a very important role, so that after 10 years of the disease the eye can be attacked up to 50%, after 15 years up to 90%. Pregnancy, HTA, smoking, obesity, hyperlipidemia also play an important role. Therefore, early detection and adequate therapy of diabetic retinopathy play a very important role in preventing the progression of the disease.

Objective: In a period of one year (2017-2018) in the eye diseases department at the General Hospital - Kumanovo, 748 patients were examined. All of these patients underwent a detailed ophthalmologic examination, which included examination of the fundus in mydriasis. Patients also completed a survey questionnaire that included: age of patients, duration of diabetes, when the first examination was performed, treatment of patients with diabetes, and whether they were aware of possible complications of diabetes on the organ of sight.