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Diabetic retinopathy

Definition

Diabetic retinopathy is a common complication of diabetes affecting the blood vessels supplying the retina. It occurs when high blood glucose, the hallmark of diabetes, has damaged the small vessels that provide oxygen and nutrients to the retina.

Reminder:
The retina is the nerve layer that lines the back of the eye, senses light, and creates impulses that travel through the optic nerve to the brain. It is composed of two parts: the macula in the centre of the retina and the peripheral retina surrounding the macula. The macula is the small yellowish central portion of the retina, measuring about 1mm in diameter. The macula provides the sharp central vision we need for reading and seeing fine details. The surrounding peripheral retina, which makes up more than 95% of the retina, is needed for peripheral vision.


Diabetes is a chronic medical condition characterised by insufficient insulin production (type 1 diabetes) or by a reduction of insulin’s effects on peripheral tissues (type 2 diabetes). Insulin stimulates cell glucose uptake, leading to a decrease in its blood concentration. In the case of insulin insufficiency, blood glucose levels rise. Diabetes is a serious disease that should not be taken lightly, as it may lead to numerous complications, notably affecting the eyes, heart, the kidneys, the nerves, etc. In order to prevent these complications, careful adherence to your doctor’s instructions is important.

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Epidemiology

Diabetes is a common disease. Worldwide, approximately 150 million subjects are affected—a number likely to double by 2025.1 Type 2 diabetes is much more common than type 1 diabetes, representing 90% of all cases worldwide.1 The risk of diabetic retinopathy is higher in patients with type 1 diabetes.2

In the United States, more than 2.5% of the population older than 18 years of age suffer from diabetic retinopathy.3In France, 35% to 40% of diabetic patients, 800,000 in total suffer from retinopathy.4 Developing countries are also seriously affected, primarily because there are not enough ophthalmologists to facilitate annual screenings.5

Worldwide, diabetic eye disease is a leading cause of poor vision and blindness. Approximately 10% of patients diagnosed with diabetes have vision problems.6 However, according to clinical trial results, early detection and prompt treatment may prevent more than 95% of the vision reductions that are observed in diabetic patients.7 If you suffer from diabetes, regular eye examinations will allow you to obtain proper therapy before it is too late.


1 Organisation mondiale de la santé. Diabète sucré. http://www.who.int/mediacentre/factsheets/fs138/fr/index.html
2 Grimaldi A. Epidémiologie des complications dégénératives du diabète sucré. Dans: EMC référence – Diabète de type 2. Elsevier 2004, p. 286-8.
3 Prevent Blindness America, National Eye Institut. Vision problems in the US - Prevalence of adult vision impairment and age-related eye disease in America. 2002.
4 Massin P. Nouveautés sur la rétinopathie diabétique. Médecine clinique endocrinologie & diabète. Hors série. Confrontations Endocrinologie - Diabétologie Sud-Franciliennes. Mars/Avril 2006, 32-9.
5 Viswanath K, Murray Mc Gavin DD. Diabetic retinopathy: clinical findings and management. Community Eye Health 2003;16:21-4.
6 Massin P. Complications oculaires du diabète: uniformiser le dépistage et les soins: Complications du diabète au long cours. La revue du praticien 2001;51:1776-82.
7 Rabasa-Lhoret, Avignon F, Monnier L et al. L’impact socio-économique du diabète sucré de type 2. Sang Thrombose Vaisseaux 1999;11:587-95.

 

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