Diabetes 20, Diabetic Retinopathy

Microvascular disease of the retina occurs as a result of basement membrane thickening. Retinal arterioles narrow and may become completely occluded. These changes lead to hypoxia in ischaemic areas of the retina. Chronic retinal hypoxia results in the release of growth factors including a factor which stimulates the rapid generation of new blood vessels. More blood vessels could carry more blood to the area and so counter the hypoxia. However there is a problem. In the retina the excessive growth of new small blood vessels is called proliferate retinopathy. These new vessels have fragile walls which can rupture and bleed; this will cause retinal haemorrhages which cause progressive damage to the light sensitive cells. Regular retinal examination and possible photocoagulation can cauterise new vessels before they have time to haemorrhage, this can prevent or delay the development of blindness. Poor glycaemic control, with hyperglycaemia is a definite risk factor for diabetic retinopathy. From this it is clear that good levels of glycaemic control reduce the probability of this complication developing. Hypertension is another risk factor for diabetic retinopathy which should therefore be managed. Diabetics are also more prone to cataracts (opacity of the lens) and glaucoma (increased pressure within the eyeball).

[@jasminethomas3139]

I'm a fourth year medical student and I have never had retinopathy explained so well. This is fantastic, thank you so much!

[@udayprabhakar6744]

Thank you sir, I am learning medical through you day by day. I am a diabetic patient.

[@adinaratzlaff246]

Your explanation are so easy to follow. Thank you!

[@haiderissa163]

No one explain it in a simple way like you...
Thanks doctor
God bless yoi

[@francesca95]

Fantastic videos. Totally helps me understand what I am looking for with the ophthalmoscope

[@hadassaalmeida728]

Great explanation. Thank you very much for sharing. God bless you and the work of your hands.

[@saraalrebaiee9510]

GREAT EXPLANATION .. BUT I WOULD LIKE TO KNOW FROM THE BEGINING WHAT IS THE MECHANISM OF THE PROLIFRATION OF B/M IS IT BECAUSE ACCUMLATION OF GLUCOSE ?

[@AlAjmi97336]

Thanks Dr. John Campbell

[@Jeffsingleton100]

Excellent Information! Thank you sir

[@walaakamal3578]

Thank you dr John
Thanks to you medicine is much easier

[@sadiqal-herz7964]

thank you

[@pickledrick5158]

Studies in diabetics rats showed that at least diabetic nephropathy was reversed with euglycemic ranges. Perhaps the endothelial proliferation is ok if the blood sugar and pressure is kept normal and allow the new blood vessels to properly grow. Is there any studies or data on diabetic humans with euglycemic ranges? I wonder if humans can also potentially reverse at least mild microvascular insults.

[@higurusakiyokamamoto]

Brilliant, thank you sir!

[@janitathomson84]

Good explanations- thank you :-)

[@mirav8221]

thank you sooo much! made it very easy to understand! :)

[@beckyrapula3484]

Thank you Doctor!

[@TheHalcyonView]

Those mechanisms that produce angiogenesis of low quality vessels is called collateral circulation???

[@alzaroc0]

obrigado

[@funnnkyk1d]

Thanks

[@loui4871]

are the capillaries already thick? or they thicken bcoz of DM? if they become thick bcoz of DM, how?

[@dynanomitetyler6080]

I had my eye exam and they said i had damage but said it wasn't bad enough to do anything any chance you know what they could have found