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Diabetic Reinopathy

First is non proliferative or background diabetic retinopathy (BDR). This represents the early stages of diabetic damage to the blood vessels of the retina. When damage occurs to the retinal vasculature, the blood vessels will leak fluid, blood, or both. This then can lead to either macular edema (swelling) or macular ischemia (poor blood flow). If macular edema develops the vision will suffer. Treatment includes local focal laser to the areas of blood vessel leakage, intraocular steroid injections, and injections of anti-VEGF agents. There is no treatment for macular ischemia.

The second type of diabetic retinopathy is proliferative retinopathy (PDR). In this disorder the blood vessels are so damaged that they occlude permanently and in order to compensate, the retina grows very delicate, new blood vessels. These new blood vessels are totally abnormal and serve no purpose. They only cause serious problems such as spontanoue hemorrhages into the vitreous cavity and the growth of significant scar tissue, which can lead to retinal detachment. If left unchecked blindness may be the final outcome. The treatment of PDR is extensive laser treatment. If a vitreous hemorrhage occurs, vitrectomy surgery is suggested. Early treatment has the best results.



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