糖尿病视网膜病变英文课件

The normal structure of the eyeballThe normal structure of the eyeball TermsTerms l l 角膜：角膜：corneacornea l l Corne/o-Corne/o-, , l l CorneaCornea角膜，角膜， l l MegacorneaMegacornea大角膜，大角膜， l l MicrocorneaMicrocornea小角膜，小角膜， l l Kerat/o-Kerat/o-, , l l KeratitisKeratitis角膜炎，角膜炎， l l KeratomalaciaKeratomalacia角膜软化症角膜软化症 l l 巩膜：巩膜：sclerasclera l l Scler/o-Scler/o-, , l l ScleritisScleritis巩膜炎，巩膜炎， l l EpiscleritisEpiscleritis表层巩膜炎，表层巩膜炎， l l EpiscleraEpisclera巩膜上层巩膜上层 l l （epi-epi-，beyond somethingbeyond something）,epidermis,epidermis表皮，上皮表皮，上皮 l l EpidermalEpidermal表皮的，外皮的表皮的，外皮的 l l 虹膜虹膜:iris:iris , , Irid/o-Irid/o-, , l l IridotomyIridotomy虹膜切开术，虹膜切开术，iridectomyiridectomy虹膜切除术，虹膜切除术，iridocyclitisiridocyclitis虹膜睫状虹膜睫状 体炎体炎 l l 睫状体：睫状体：ciliary bodyciliary body l l 脉络膜脉络膜:choroid:choroid , , Choroid/o-Choroid/o-, , l l choroidalchoroidal脉络膜的，脉络膜的，choroidoretinitischoroidoretinitis脉络膜视网膜炎脉络膜视网膜炎 l l 视网膜：视网膜：retin/oretin/o l l retinitisretinitis视网膜炎，视网膜炎，retinopathyretinopathy视网膜病变视网膜病变,diabetic retinopathy,diabetic retinopathy糖尿糖尿 病视网膜病变病视网膜病变 瞳孔瞳孔:pupil:pupil , ,Pupill/o-Pupill/o-,pupillomotor,pupillomotor瞳孔运动的，瞳孔运动的，pupillometerpupillometer瞳孔计瞳孔计 l l 玻璃体玻璃体:vitreous:vitreous , , Vitre/o-Vitre/o-, , l l vitreousvitreous玻璃体的玻璃体的,Vitrectomy,Vitrectomy玻璃体切除术玻璃体切除术, , l l VitreretinalVitreretinal玻璃体视网膜的玻璃体视网膜的,Vitreretinopathy,Vitreretinopathy玻璃体视网膜病变玻璃体视网膜病变 l l 晶状体：晶状体：lenslens l l 视盘：视盘：optic diskoptic disk l l 黄斑黄斑:macular:macular l l 视神经：视神经：optic nerveoptic nerve l l 中央凹中央凹:Fovea:Fovea Diabetic retinopathyDiabetic retinopathy l l DefinitionDefinition l l CausesCauses l l SymptomsSymptoms l l Risk factorsRisk factors l l Tests and diagnosisTests and diagnosis l l When to seek medical advice When to seek medical advice l l ComplicationsComplications l l Treatments and drugsTreatments and drugs l l PreventionPrevention Diabetic retinopathy Causes Causes l l When you have diabetes, your body When you have diabetes, your body doesnt use sugar (glucose) properly. doesnt use sugar (glucose) properly. CausesCauses l l If your blood sugar level is too high, your If your blood sugar level is too high, your natural lens may swell natural lens may swell which can blur which can blur your vision. your vision. CausesCauses l l Eventually, too much sugar in your blood Eventually, too much sugar in your blood can damage the tiny blood vessels can damage the tiny blood vessels ( (capillariescapillaries毛细血管毛细血管) that nourish the ) that nourish the retina. This can result in diabetic retina. This can result in diabetic retinopathy.retinopathy. l l capillarycapillary ,Capill/o- , ,Capill/o- , n.& adj.n.& adj.毛细管毛细管( (的的) ) l l CapillaritisCapillaritis毛细管炎毛细管炎 Symptoms Symptoms l l At first, diabetic retinopathy may cause no At first, diabetic retinopathy may cause no symptoms or only mild vision problems.symptoms or only mild vision problems. Symptoms Symptoms l l You can have diabetic retinopathy You can have diabetic retinopathy and not know it. In fact, symptoms and not know it. In fact, symptoms are unusual in the early stages of are unusual in the early stages of diabetic retinopathy. diabetic retinopathy. Symptoms Symptoms l l Eventually, however, diabetic retinopathy Eventually, however, diabetic retinopathy can result in blindness. can result in blindness. l l In In ChinaChina ,diabetic retinopathy is a leading ,diabetic retinopathy is a leading cause of blindness in adults. cause of blindness in adults. symptomssymptoms l l In fact, up to 45 percent of adults In fact, up to 45 percent of adults diagnosed with diabetes indiagnosed with diabetes in China China have have some degree of diabetic retinopathy, some degree of diabetic retinopathy, according to the National Eye Institute. according to the National Eye Institute. symptomssymptoms l l And the longer you have diabetes, the And the longer you have diabetes, the more likely you are to develop diabetic more likely you are to develop diabetic retinopathy. retinopathy. SymptomsSymptoms l l Diabetic retinopathy usually affects Diabetic retinopathy usually affects both eyes. both eyes. SymptomsSymptoms l l As the condition progresses, diabetic As the condition progresses, diabetic retinopathy symptoms may include: retinopathy symptoms may include: A) Spots floating in your vision A) Spots floating in your vision B) Blurred visionB) Blurred vision C)Dark streaks or a red film that blocks C)Dark streaks or a red film that blocks your vision your vision D) Poor night visionD) Poor night vision E) Vision lossE) Vision loss Diabetic retinopathy is usually Diabetic retinopathy is usually classified as early or advanced.classified as early or advanced. l l Early diabetic retinopathy.Early diabetic retinopathy. Nonproliferative diabetic retinopathy Nonproliferative diabetic retinopathy (NPDR) is the most common type of (NPDR) is the most common type of diabetic retinopathy. It can be described diabetic retinopathy. It can be described as mild, moderate or severe. as mild, moderate or severe. l l NPDR : (Non Prolifertive Dibetic Retinopthy)NPDR : (Non Prolifertive Dibetic Retinopthy) l l 非增殖性糖尿病视网膜病变非增殖性糖尿病视网膜病变 l l When you have NPDR, the walls of the When you have NPDR, the walls of the blood vessels in your retina weaken. blood vessels in your retina weaken. l l Tiny bulgesTiny bulges（凸起）（凸起） protrudeprotrude（伸入）（伸入） from the vessel walls, sometimes leaking from the vessel walls, sometimes leaking or oozing fluid and blood into the retina. or oozing fluid and blood into the retina. These bulges are called microaneurysms. These bulges are called microaneurysms. l l Microaneurysms : Microaneurysms : 微动脉瘤，微血管瘤微动脉瘤，微血管瘤 In the early stages of diabetic retinopathy, the walls of the blood vessels in your retina weaken. Tiny bulges protrude from the vessel walls, sometimes leaking or oozing fluid and blood into the retina. As diabetic retinopathy progresses, new blood vessels may grow and threaten your vision. As the condition progresses, the As the condition progresses, the smaller vessels may close entirely and smaller vessels may close entirely and the larger retinal veins may begin to the larger retinal veins may begin to dilatedilate（扩大）（扩大） and become irregular in and become irregular in diameterdiameter（直径）（直径） . . Nerve fibers in the retina may begin to Nerve fibers in the retina may begin to swell. swell. l l Sometimes the central part of the retina Sometimes the central part of the retina (macula) begins to swell, too. This is (macula) begins to swell, too. This is known as known as macular edema. macular edema. l l Macula : Macula : 黄斑黄斑 l l Macular edema Macular edema ：黄斑水肿：黄斑水肿 termsterms l l Extensive Extensive ：广泛的，大量的：广泛的，大量的 l l Intraretinal microvascular abnormalitis Intraretinal microvascular abnormalitis （IRMAIRMA）视网膜）视网膜 内微血管异常内微血管异常 l l Intraretinal : Intraretinal : 视网膜内部的视网膜内部的 l l Microvascular Microvascular ：微血管的：微血管的 l l Cotton wool spots : Cotton wool spots : 棉绒斑棉绒斑 l l Hemorrhage Hemorrhage ：出血：出血 l l Roots that means bloodRoots that means blood：Hemo- Hemo- ，hema- ,hem-, hema- ,hem-, haemo- ,haema- ,haem-haemo- ,haema- ,haem- l l -rrhage-rrhage , ,出血，流血出血，流血 l l Gastrointestinalrrhage Gastrointestinalrrhage 消化道出血消化道出血 l l Advanced diabetic retinopathy.Advanced diabetic retinopathy. Proliferative diabetic retinopathy (PDR) is Proliferative diabetic retinopathy (PDR) is the most severe type of diabetic the most severe type of diabetic retinopathy. retinopathy. l l When you have PDR, abnormal blood When you have PDR, abnormal blood vessels grow in the retina. vessels grow in the retina. l l Sometimes the new blood vessels grow or Sometimes the new blood vessels grow or leak into the leak into the vitreousvitreous (the clear, jelly-like (the clear, jelly-like substance that fills the center of your eye substance that fills the center of your eye ). ). l l 玻璃体玻璃体:vitreous :vitreous ，Vitre/o-,Vitre/o-, l l vitreousvitreous玻璃体的玻璃体的, , l l VitrectomyVitrectomy玻璃体切除术玻璃体切除术, , l l Jelly-like :Jelly-like :胶状的胶状的 l l Eventually, scar tissue stimulated by the Eventually, scar tissue stimulated by the growth of new blood vessels may cause growth of new blood vessels may cause the retina to detachthe retina to detach（脱离）（脱离） from the from the back of your eye. back of your eye. l l If the new blood vessels interfere If the new blood vessels interfere with the normal flow of fluid out of with the normal flow of fluid out of the eye, pressure may build up in the the eye, pressure may build up in the eyeball. This can damage the eyeball. This can damage the optic optic nervenerve . (The nerve that carries . (The nerve that carries images from your eye to your brain ). images from your eye to your brain ). l l Peripheral : Peripheral : 外围的，不重要的外围的，不重要的 l l Peri-Peri- ，外围的，周围的，外围的，周围的 l l Perinatal Perinatal 围产期的，出生前后的围产期的，出生前后的 l l Periportal Periportal 门静脉周的，门静脉周的， l l Periarteritis Periarteritis 动脉周围炎，动脉周围炎， l l periappendicitis periappendicitis 阑尾周炎阑尾周炎 l l Exudative maculopathy : Exudative maculopathy : 渗出性黄斑病变渗出性黄斑病变 l l Hard exudates :Hard exudates :硬渗出物硬渗出物 l l Hard exudates and hemorrhages lateral to Hard exudates and hemorrhages lateral to macula macula ：单侧性黄斑硬性渗出和出血：单侧性黄斑硬性渗出和出血 l l Lateral :Lateral :侧部的侧部的 l l Apparent Apparent ：明显的：明显的 l l Quadrant Quadrant ：象限，四分之一圆：象限，四分之一圆 l l Prominent Prominent ：显著的：显著的 Risk factors Risk factors Diabetic retinopathy can happen to Diabetic retinopathy can happen to anyone who has diabetes. The risk is anyone who has diabetes. The risk is highest if you: highest if you: Risk factorsRisk factors l l Have poor control of your blood sugar levelHave poor control of your blood sugar level l l Have high blood pressureHave high blood pressure l l Have high cholesterolHave high cholesterol l l Are pregnantAre pregnant l l Are black or HispanicAre black or Hispanic l l SmokeSmoke l l Hispanic Hispanic ：西班牙人：西班牙人 l l Cholesterol Cholesterol ：胆固醇：胆固醇 Risk factorsRisk factors The longer you have diabetes, the greater The longer you have diabetes, the greater your risk of developing diabetic your risk of developing diabetic retinopathy. retinopathy. When to seek medical advice When to seek medical advice l l Early detection of diabetic retinopathy is the Early detection of diabetic retinopathy is the best way to prevent vision lossbest way to prevent vision loss: : l l （a a）If you have diabetes, see your eye doctor for a If you have diabetes, see your eye doctor for a yearly yearly dilateddilated eye exameye exam（扩瞳检查）（扩瞳检查） even if your even if your vision seems fine.vision seems fine. l l （b b）If you become pregnant, your eye doctor may If you become pregnant, your eye doctor may recommend additional eye exams throughout your recommend additional eye exams throughout your pregnancy. pregnancy. l l (c) (c)Contact your eye doctor right away if you experience Contact your eye doctor right away if you experience sudden vision changes or your vision becomes blurry, sudden vision changes or your vision becomes blurry, spotty or hazyspotty or hazy（模糊或有斑点）（模糊或有斑点）. . ComplicationsComplications The abnormal growth of new blood The abnormal growth of new blood vessels in the retina can lead to vessels in the retina can lead to serious vision problems: serious vision problems: l l Vitreous hemorrhage.Vitreous hemorrhage. The new blood The new blood vessels may bleed into the clear, jelly-like vessels may bleed into the clear, jelly-like substance that fills the center of your eyesubstance that fills the center of your eye （vitreousvitreous）. . l l Retinal detachmentRetinal detachment（视网膜脱离）（视网膜脱离）. . This may cause blurred vision, spots This may cause blurred vision, spots floating in your vision or severe vision loss.floating in your vision or severe vision loss. l l Glaucoma.Glaucoma. The new blood vessels may The new blood vessels may interfere with the normal flow of fluid out interfere with the normal flow of fluid out of the eye and cause pressure in the eye of the eye and cause pressure in the eye to build up. to build up. l l Blindness.Blindness. Eventually, diabetic Eventually, diabetic retinopathy can lead to complete vision retinopathy can lead to complete vision loss. loss. l l Glaucoma Glaucoma ：青光眼：青光眼 Tests and diagnosisTests and diagnosis Diabetic retinopathy is best diagnosed with a Diabetic retinopathy is best diagnosed with a dilated eye exam. During the exam, your eye dilated eye exam. During the exam, your eye doctor will look for: doctor will look for: l l Abnormal blood vesselsAbnormal blood vessels l l Swelling, blood or fatty deposits in the retina Swelling, blood or fatty deposits in the retina l l Damage to the nerve tissueDamage to the nerve tissue l l Growth of new blood vessels and scar tissueGrowth of new blood vessels and scar tissue l l Bleeding in the vitreousBleeding in the vitreous l l Retinal detachmentRetinal detachment Tests and diagnosisTests and diagnosis l l As part of the eye exam, your doctor may As part of the eye exam, your doctor may do a retinal photography test called do a retinal photography test called fluorescein angiography. fluorescein angiography. l l Your doctor also may request an optical Your doctor also may request an optical coherence tomography (OCT) exam. coherence tomography (OCT) exam. l l Fundus fluorescein angiography (FFA)Fundus fluorescein angiography (FFA)荧光素眼底血管造荧光素眼底血管造 影术影术 l l Fundus Fundus 眼底，基底，宫底，眼底，基底，宫底，Fluorescein Fluorescein 荧光素，荧光素， angiography angiography 血管造影术血管造影术 l l Fundus hemorrhage Fundus hemorrhage 眼底出血眼底出血 l l Optical coherence tomography Optical coherence tomography （OCTOCT）光）光 学相干断层扫描学相干断层扫描 l l Coherence Coherence 连续性，相关性，一致性连续性，相关性，一致性 l l Tomography Tomography ：X X线断层摄影术线断层摄影术 =laminography=laminography TreatmentsTreatments Treatment for diabetic retinopathy Treatment for diabetic retinopathy depends on the type of diabetic depends on the type of diabetic retinopathy you have, its severity and how retinopathy you have, its severity and how well it may respond to specific treatments. well it may respond to specific treatments. Early diabetic retinopathyEarly diabetic retinopathy l l If you have nonproliferative diabetic If you have nonproliferative diabetic retinopathy, you may not need retinopathy, you may not need treatment right away. treatment right away. l l However, your eye doctor will closely However, your eye doctor will closely monitor your retina to determine if you monitor your retina to determine if you need laser treatment.need laser treatment. Advanced diabetic Advanced diabetic retinopathyretinopathy l l If you have proliferative diabetic If you have proliferative diabetic retinopathy, youll need prompt surgical retinopathy, youll need prompt surgical treatment. treatment. l l Sometimes surgery is recommended for Sometimes surgery is recommended for severe nonproliferative diabetic severe nonproliferative diabetic retinopathy, too.retinopathy, too. l l Depending on the specific problems with Depending on the specific problems with your retina, options may include: your retina, options may include: Treatments and drugs Treatments and drugs l l laser treatmentlaser treatment l l surgical treatment. surgical treatment. l l VirtectomyVirtectomy Prevention Prevention l l Remember, diabetes doesnt necessarily Remember, diabetes doesnt necessarily doom you to poor vision. Taking an active doom you to poor vision. Taking an active role in diabetes management can go a role in diabetes management can go a long way toward preventing complications.long way toward preventing complications. l l Doom Doom 宣告厄运宣告厄运 PreventionPrevention l l Make a commitment to managing Make a commitment to managing your diabetes.your diabetes. l l Monitor your blood sugar level.Monitor your blood s