糖尿病視網(wǎng)膜病變

Diabeticretinopathy

糖尿病視網(wǎng)膜病變

內(nèi)分泌28區(qū)ThenormalstructureoftheeyeballDiabeticretinopathy

糖尿病視網(wǎng)膜病變

Definition(定義）

Causes

（病因）Symptoms

（癥狀）Riskfactors

（風(fēng)險因素）Testsanddiagnosis

（測試與診斷）Whentoseekmedicaladvice（何時尋求醫(yī)療意見）Complications(并發(fā)癥）Treatmentsanddrugs

（藥物治療）Prevention

（預(yù)防）DiabeticretinopathyDefinition

Diabeticretinopathyisacomplicationofdiabetesthatresultsfromdamagetothebloodvesselsofthelight-sensitivetissueatthebackoftheeye(retina).糖尿病視網(wǎng)膜病變是在眼睛后部的感光組織血管損傷causeDiabeticretinopathycanhappentoanyonewhohastype1diabetesortype2diabetes.糖尿病性視網(wǎng)膜病變可發(fā)生于任何有1型糖尿病或2型糖尿病的人CausesWhenyouhavediabetes,yourbodydoesn'tusesugar(glucose)properly.當(dāng)你有糖尿病，你的身體不能正常的使用糖（葡萄糖）CausesIfyourbloodsugarlevelistoohigh,yournaturallensmayswell—whichcanbluryourvision.如果你的血糖水平太高，你的自然晶狀體會腫脹--這會使你的視力模糊。CausesEventually,toomuchsugarinyourbloodcandamagethetinybloodvessels(capillaries毛細血管)thatnourishtheretina.Thiscanresultindiabeticretinopathy.最終，你的血液中過多的糖會損害微小血管（毛細血管毛細血管）滋養(yǎng)視網(wǎng)膜。這可能導(dǎo)致糖尿病性視網(wǎng)膜病變。SymptomsAtfirst,diabeticretinopathymaycausenosymptomsoronlymildvisionproblems.起初，糖尿病性視網(wǎng)膜病變可能導(dǎo)致沒有癥狀或只有輕微的視力問題symptomsAndthelongeryouhavediabetes,themorelikelyyouaretodevelopdiabeticretipnoathy.時間越長，你有糖尿病，你就越有可能發(fā)生糖尿病視網(wǎng)膜病變SymptomsAstheconditionprogresses,diabeticretinopathysymptomsmayinclude:A)SpotsfloatinginyourvisionB)BlurredvisionC)DarkstreaksoraredfilmthatblocksyourvisionD)PoornightvisionE)Visionloss隨著病情的進展，糖尿病視網(wǎng)膜病變的癥狀可能包括：A在你的視野中漂浮物體B視力模糊C暗條紋或紅色的薄膜，擋住你的視線D夜間視力差E視力喪失Diabeticretinopathyisusuallyclassifiedasearlyoradvanced.

糖尿病性視網(wǎng)膜病變通常分為早期或晚期。

Earlydiabeticretinopathy.Nonproliferativediabeticretinopathy(NPDR)isthemostcommontypeofdiabeticretinopathy.Itcanbedescribedasmild,moderateorsevere.早期糖尿病視網(wǎng)膜病變。非增殖性糖尿病視網(wǎng)膜病變（DR）是糖尿病視網(wǎng)膜病變的最常見類型。它可以被描述為輕度，中度或重度。WhenyouhaveNPDR,thewallsofthebloodvesselsinyourretinaweaken.當(dāng)你的眼睛有糖尿病視網(wǎng)膜病變，你的視網(wǎng)膜血管壁削弱。Tinybulges（凸起）protrude（伸入）fromthevesselwalls,sometimesleakingoroozingfluidandbloodintotheretina.Thesebulgesarecalledmicroaneurysms.微小的凸起（凸起）突出（伸入）從血管壁，有時漏水或滲液和血液進入視網(wǎng)膜。這些凸起稱為微動脈瘤。Intheearlystagesofdiabeticretinopathy,thewallsofthebloodvesselsinyourretinaweaken.Tinybulgesprotrudefromthevesselwalls,sometimesleakingoroozingfluidandbloodintotheretina.Asdiabeticretinopathyprogresses,newbloodvesselsmaygrowandthreatenyourvision.在糖尿病視網(wǎng)膜病變的早期，血管的壁在你的視網(wǎng)膜減弱。微小的突起與血管壁突出，有時漏水或滲液和血液進入視網(wǎng)膜。隨著糖尿病視網(wǎng)膜病變的進展，新的血管可能會增并威脅你的視力。Astheconditionprogresses,thesmallervesselsmaycloseentirelyandthelargerretinalveinsmaybegintodilate（擴大）andbecomeirregularindiameter（直徑）.Nervefibersintheretinamaybegintoswell.隨著病情的進展，小血管可能完全關(guān)閉，而較大的視網(wǎng)膜靜脈開始擴張（擴大）和直徑（直徑）變得不規(guī)則。Sometimesthecentralpartoftheretina(macula)beginstoswell,too.Thisisknownasmacularedema.在視網(wǎng)膜神經(jīng)纖維可能開始膨脹，有時視網(wǎng)膜的中央部分（黑點）開始膨脹，太。這就是被稱為黃斑水腫。Advanceddiabeticretinopathy.Proliferativediabeticretinopathy(PDR)isthemostseveretypeofdiabeticretinopathy.晚期糖尿病視網(wǎng)膜病變。增殖性糖尿病視網(wǎng)膜病變（DR）是糖尿病視網(wǎng)膜病變最嚴重的類型。WhenyouhavePDR,abnormalbloodvesselsgrowintheretina.當(dāng)你有了PDR，異常血管生長在視網(wǎng)膜。Sometimesthenewbloodvesselsgroworleakintothevitreous(theclear,jelly-likesubstancethatfillsthecenterofyoureye).有時，新的血管生長或泄漏到玻璃體（明確的，果凍狀的物質(zhì)，填補了你的眼睛中心）。Eventually,scartissuestimulatedbythegrowthofnewbloodvesselsmaycausetheretinatodetach（脫離）fromthebackofyoureye.最終，瘢痕組織的新血管生長刺激可引起視網(wǎng)膜脫離（脫離）從你的眼睛后面。Ifthenewbloodvesselsinterferewiththenormalflowoffluidoutoftheeye,pressuremaybuildupintheeyeball.Thiscandamagetheopticnerve.如果新的血管會干擾正常的液體流出，在眼球內(nèi)壓力可能會出現(xiàn)。這會損害視神經(jīng)。（從你的眼睛到你的大腦的神經(jīng)）。RiskfactorsDiabeticretinopathycanhappentoanyonewhohasdiabetes.Theriskishighestifyou:

糖尿病性視網(wǎng)膜病變可

發(fā)生在任何有糖尿病的

人身上。風(fēng)險是最高的

，如果你：RiskfactorsHavepoorcontrolofyourbloodsugarlevelHavehighbloodpressureHavehighcholesterolArepregnantAreblackorHispanicSmoke控制你的血糖水平有高血壓高膽固醇懷孕了是黑人或西班牙裔煙RiskfactorsThelongeryouhavediabetes,thegreateryourriskofdevelopingdiabeticretinopathy.你患糖尿病的時間越長，患糖尿病視網(wǎng)膜病變的風(fēng)險越大。WhentoseekmedicaladviceEarlydetectionofdiabeticretinopathyisthebestwaytopreventvisionloss:蛋白試驗。糖尿病視網(wǎng)膜病變的早期檢測是防止視力喪失的最好方法：（a）Ifyouhavediabetes,seeyoureyedoctorforayearlydilatedeyeexam（擴瞳檢查）—evenifyourvisionseemsfine.如果你有糖尿病，看到你的眼睛醫(yī)生每年散瞳檢查（擴瞳檢查）-即使你的視力很好。（b）Ifyoubecomepregnant,youreyedoctormayrecommendadditionaleyeexamsthroughoutyourpregnancy.如果你懷孕了，你的眼睛醫(yī)生可能會建議你在懷孕期間做更多的眼科檢查。(c)Contactyoureyedoctorrightawayifyouexperiencesuddenvisionchangesoryourvisionbecomesblurry,spottyorhazy（模糊或有斑點）.接觸你的眼科醫(yī)生立即如果您遇到視力突然改變，或你的視野變得模糊，呈點狀或朦朧（模糊或有斑點）。Complications

Theabnormalgrowthofnewbloodvesselsintheretinacanleadtoseriousvisionproblems:視網(wǎng)膜新生血管的異常生長可能導(dǎo)致嚴重的視力問題：Vitreoushemorrhage.Thenewbloodvesselsmaybleedintotheclear,jelly-likesubstancethatfillsthecenterofyoureye（vitreous）.

Retinaldetachment（視網(wǎng)膜脫離）.Thismaycauseblurredvision,spotsfloatinginyourvisionorseverevisionloss.玻璃體出血。新的血管可能會出血，像物質(zhì)，填充你的眼睛（玻璃體）的中心。視網(wǎng)膜脫離（視網(wǎng)膜脫離）。這可能會導(dǎo)致視力模糊，在你的視覺或嚴重視力喪失浮動。Glaucoma.Thenewbloodvesselsmayinterferewiththenormalflowoffluidoutoftheeyeandcausepressureintheeyetobuildup.Blindness.Eventually,diabeticretinopathycanleadtocompletevisionloss.青光眼。新的血管可能會干擾眼睛的正常流動，引起眼睛的壓力，以建立。失明。最終，糖尿病視網(wǎng)膜病變可導(dǎo)致視力喪失。TestsanddiagnosisDiabeticretinopathyisbestdiagnosedwithadilatedeyeexam.Duringtheexam,youreyedoctorwilllookfor:糖尿病視網(wǎng)膜病變最好診斷為擴張眼檢查。在考試中，你的眼科醫(yī)生會尋找：Abnormalbloodvessels血管異常Swelling,bloodorfattydepositsintheretina視網(wǎng)膜上的腫脹、血液或脂肪沉積Damagetothenervetissue對神經(jīng)組織的損傷Growthofnewbloodvesselsandscartissue新生血管和瘢痕組織的生長Bleedinginthevitreous玻璃體出血Retinaldetachment視網(wǎng)膜脫離TestsanddiagnosisAspartoftheeyeexam,yourdoctormaydoaretinalphotographytestcalledfluoresceinangiography.Yourdoctoralsomayrequestanopticalcoherencetomography(OCT)exam.作為眼科檢查的一部分，你的醫(yī)生可能會做一個叫做熒光血管造影的視網(wǎng)膜攝影檢查。你的醫(yī)生也可能要求光學(xué)相干斷層掃描檢查。TreatmentsTreatmentfordiabeticretinopathydependsonthetypeofdiabeticretinopathyyouhave,itsseverityandhowwellitmayrespondtospecifictreatments.糖尿病視網(wǎng)膜病變的治療取決于糖尿病視網(wǎng)膜病變的類型，其嚴重程度以及它對特定治療的反應(yīng)程度。Earlydiabeticretinopathy

早期糖尿病視網(wǎng)膜病變

Ifyouhavenonproliferativediabeticretinopathy,youmaynotneedtreatmentrightaway.However,youreyedoctorwillcloselymonitoryourretinatodetermineifyouneedlasertreatment.如果你有非增殖性糖尿病視網(wǎng)膜病變，你可能不需要馬上治療。然而，你的眼睛醫(yī)生會密切監(jiān)測你的視網(wǎng)膜，以確定是否需要激光治療。Advanceddiabeticretinopathy

晚期糖尿病視網(wǎng)膜病變Ifyouhaveproliferativediabeticretinopathy,you'llneedpromptsurgicaltreatment.Sometimessurgeryisrecommendedforseverenonproliferativediabeticretinopathy,too.Dependingonthespecificproblemswithyourretina,optionsmayinclude:如果你有增生性糖尿病視網(wǎng)膜病變，你需要及時手術(shù)治療。有時手術(shù)被推薦用于重度非增殖性糖尿病視網(wǎng)膜病變。根據(jù)您的視網(wǎng)膜上的具體問題，選項可能包括：Treatmentsanddrugslasertreatmentsurgicaltreatment.Virtectomy激光治療外科治療。玻璃體手術(shù)PreventionRemember,diabetesdoesn'tnecessarilydoomyoutopoorvision.Takinganactiveroleindiabetesmanagementcangoalongwaytowardp