A Brief Note On Diabetic Retinopathy ( Dr ) Is A Common Microvascular Complication
1621 WordsMay 7, 20167 Pages
Diabetic retinopathy (DR) is a common microvascular complication of diabetes1. The presentation of DR is a visual indication of longstanding diabetes and is a significant cause of vision impairment.
In 2015, it was estimated there were 415 million sufferers worldwide (1 in 11), increasing to 642 million (1 in 10)2 by 2040. Of those suffering diabetes, DR impacts approximately 4.2 million people, and this number is predicted to rise to 16 million by 20502. The prevalence of DR does not mirror that of diabetes, as there is a combination of causation factors. A review by Cai and Boulton (3) proposed that one of the initiating factors of DR is hyperglycaemia. This is supported by Hammes et al (4) who emphasise the impact of…show more content…
The disease has a predictable progression, advancing from the initial non-proliferative DR (NPDR), which can be asymptomatic, to the end-stage proliferative type (PDR). The rate and onset of progression is variable, as it is affected by blood pressure and blood sugar levels1. The features of NPDR include: microaneurysms, haemorrhages and exudation. Additionally PDR involves neovascularisation, resulting in vision loss. Diabetic macular oedema (DME) is also a cause of vision loss. Thickening of the retina at the macula can occur at any stage of DR, leading to blurred or distorted central vision1.
This report outlines a case of PDR, unmanaged for several years. It is interesting to note the impact of well-controlled blood pressure on the progression of the PDR.
A 74-year-old Caucasian female presented to the Queensland University of Technology optometry clinic as a new patient, following self-referral. She presented with a complaint of ‘blank areas when reading’, of approximately 4 months duration. Past ocular history included bilateral cataract removal 10 years ago (by an overseas ophthalmologist). She was diagnosed with non-insulin dependent diabetes mellitus (Type 2) 30 years ago and reported unstable management with metformin. Current blood pressure is 144/82mmHg, showing good control of her hypertension