糖尿病视网膜病变

Diabeticretinopathy

糖尿病视网膜病变

内分泌28区ThenormalstructureoftheeyeballDiabeticretinopathy

糖尿病视网膜病变

Definition(定义）

Causes

（病因）Symptoms

（症状）Riskfactors

（风险因素）Testsanddiagnosis

（测试与诊断）Whentoseekmedicaladvice（何时寻求医疗意见）Complications(并发症）Treatmentsanddrugs

（药物治疗）Prevention

（预防）DiabeticretinopathyDefinition

Diabeticretinopathyisacomplicationofdiabetesthatresultsfromdamagetothebloodvesselsofthelight-sensitivetissueatthebackoftheeye(retina).糖尿病视网膜病变是在眼睛后部的感光组织血管损伤causeDiabeticretinopathycanhappentoanyonewhohastype1diabetesortype2diabetes.糖尿病性视网膜病变可发生于任何有1型糖尿病或2型糖尿病的人CausesWhenyouhavediabetes,yourbodydoesn'tusesugar(glucose)properly.当你有糖尿病，你的身体不能正常的使用糖（葡萄糖）CausesIfyourbloodsugarlevelistoohigh,yournaturallensmayswell—whichcanbluryourvision.如果你的血糖水平太高，你的自然晶状体会肿胀--这会使你的视力模糊。CausesEventually,toomuchsugarinyourbloodcandamagethetinybloodvessels(capillaries毛细血管)thatnourishtheretina.Thiscanresultindiabeticretinopathy.最终，你的血液中过多的糖会损害微小血管（毛细血管毛细血管）滋养视网膜。这可能导致糖尿病性视网膜病变。SymptomsAtfirst,diabeticretinopathymaycausenosymptomsoronlymildvisionproblems.起初，糖尿病性视网膜病变可能导致没有症状或只有轻微的视力问题symptomsAndthelongeryouhavediabetes,themorelikelyyouaretodevelopdiabeticretipnoathy.时间越长，你有糖尿病，你就越有可能发生糖尿病视网膜病变SymptomsAstheconditionprogresses,diabeticretinopathysymptomsmayinclude:A)SpotsfloatinginyourvisionB)BlurredvisionC)DarkstreaksoraredfilmthatblocksyourvisionD)PoornightvisionE)Visionloss随着病情的进展，糖尿病视网膜病变的症状可能包括：A在你的视野中漂浮物体B视力模糊C暗条纹或红色的薄膜，挡住你的视线D夜间视力差E视力丧失Diabeticretinopathyisusuallyclassifiedasearlyoradvanced.

糖尿病性视网膜病变通常分为早期或晚期。

Earlydiabeticretinopathy.Nonproliferativediabeticretinopathy(NPDR)isthemostcommontypeofdiabeticretinopathy.Itcanbedescribedasmild,moderateorsevere.早期糖尿病视网膜病变。非增殖性糖尿病视网膜病变（DR）是糖尿病视网膜病变的最常见类型。它可以被描述为轻度，中度或重度。WhenyouhaveNPDR,thewallsofthebloodvesselsinyourretinaweaken.当你的眼睛有糖尿病视网膜病变，你的视网膜血管壁削弱。Tinybulges（凸起）protrude（伸入）fromthevesselwalls,sometimesleakingoroozingfluidandbloodintotheretina.Thesebulgesarecalledmicroaneurysms.微小的凸起（凸起）突出（伸入）从血管壁，有时漏水或渗液和血液进入视网膜。这些凸起称为微动脉瘤。Intheearlystagesofdiabeticretinopathy,thewallsofthebloodvesselsinyourretinaweaken.Tinybulgesprotrudefromthevesselwalls,sometimesleakingoroozingfluidandbloodintotheretina.Asdiabeticretinopathyprogresses,newbloodvesselsmaygrowandthreatenyourvision.在糖尿病视网膜病变的早期，血管的壁在你的视网膜减弱。微小的突起与血管壁突出，有时漏水或渗液和血液进入视网膜。随着糖尿病视网膜病变的进展，新的血管可能会增并威胁你的视力。Astheconditionprogresses,thesmallervesselsmaycloseentirelyandthelargerretinalveinsmaybegintodilate（扩大）andbecomeirregularindiameter（直径）.Nervefibersintheretinamaybegintoswell.随着病情的进展，小血管可能完全关闭，而较大的视网膜静脉开始扩张（扩大）和直径（直径）变得不规则。Sometimesthecentralpartoftheretina(macula)beginstoswell,too.Thisisknownasmacularedema.在视网膜神经纤维可能开始膨胀，有时视网膜的中央部分（黑点）开始膨胀，太。这就是被称为黄斑水肿。Advanceddiabeticretinopathy.Proliferativediabeticretinopathy(PDR)isthemostseveretypeofdiabeticretinopathy.晚期糖尿病视网膜病变。增殖性糖尿病视网膜病变（DR）是糖尿病视网膜病变最严重的类型。WhenyouhavePDR,abnormalbloodvesselsgrowintheretina.当你有了PDR，异常血管生长在视网膜。Sometimesthenewbloodvesselsgroworleakintothevitreous(theclear,jelly-likesubstancethatfillsthecenterofyoureye).有时，新的血管生长或泄漏到玻璃体（明确的，果冻状的物质，填补了你的眼睛中心）。Eventually,scartissuestimulatedbythegrowthofnewbloodvesselsmaycausetheretinatodetach（脱离）fromthebackofyoureye.最终，瘢痕组织的新血管生长刺激可引起视网膜脱离（脱离）从你的眼睛后面。Ifthenewbloodvesselsinterferewiththenormalflowoffluidoutoftheeye,pressuremaybuildupintheeyeball.Thiscandamagetheopticnerve.如果新的血管会干扰正常的液体流出，在眼球内压力可能会出现。这会损害视神经。（从你的眼睛到你的大脑的神经）。RiskfactorsDiabeticretinopathycanhappentoanyonewhohasdiabetes.Theriskishighestifyou:

糖尿病性视网膜病变可

发生在任何有糖尿病的

人身上。风险是最高的

，如果你：RiskfactorsHavepoorcontrolofyourbloodsugarlevelHavehighbloodpressureHavehighcholesterolArepregnantAreblackorHispanicSmoke控制你的血糖水平有高血压高胆固醇怀孕了是黑人或西班牙裔烟RiskfactorsThelongeryouhavediabetes,thegreateryourriskofdevelopingdiabeticretinopathy.你患糖尿病的时间越长，患糖尿病视网膜病变的风险越大。WhentoseekmedicaladviceEarlydetectionofdiabeticretinopathyisthebestwaytopreventvisionloss:蛋白试验。糖尿病视网膜病变的早期检测是防止视力丧失的最好方法：（a）Ifyouhavediabetes,seeyoureyedoctorforayearlydilatedeyeexam（扩瞳检查）—evenifyourvisionseemsfine.如果你有糖尿病，看到你的眼睛医生每年散瞳检查（扩瞳检查）-即使你的视力很好。（b）Ifyoubecomepregnant,youreyedoctormayrecommendadditionaleyeexamsthroughoutyourpregnancy.如果你怀孕了，你的眼睛医生可能会建议你在怀孕期间做更多的眼科检查。(c)Contactyoureyedoctorrightawayifyouexperiencesuddenvisionchangesoryourvisionbecomesblurry,spottyorhazy（模糊或有斑点）.接触你的眼科医生立即如果您遇到视力突然改变，或你的视野变得模糊，呈点状或朦胧（模糊或有斑点）。Complications

Theabnormalgrowthofnewbloodvesselsintheretinacanleadtoseriousvisionproblems:视网膜新生血管的异常生长可能导致严重的视力问题：Vitreoushemorrhage.Thenewbloodvesselsmaybleedintotheclear,jelly-likesubstancethatfillsthecenterofyoureye（vitreous）.

Retinaldetachment（视网膜脱离）.Thismaycauseblurredvision,spotsfloatinginyourvisionorseverevisionloss.玻璃体出血。新的血管可能会出血，像物质，填充你的眼睛（玻璃体）的中心。视网膜脱离（视网膜脱离）。这可能会导致视力模糊，在你的视觉或严重视力丧失浮动。Glaucoma.Thenewbloodvesselsmayinterferewiththenormalflowoffluidoutoftheeyeandcausepressureintheeyetobuildup.Blindness.Eventually,diabeticretinopathycanleadtocompletevisionloss.青光眼。新的血管可能会干扰眼睛的正常流动，引起眼睛的压力，以建立。失明。最终，糖尿病视网膜病变可导致视力丧失。TestsanddiagnosisDiabeticretinopathyisbestdiagnosedwithadilatedeyeexam.Duringtheexam,youreyedoctorwilllookfor:糖尿病视网膜病变最好诊断为扩张眼检查。在考试中，你的眼科医生会寻找：Abnormalbloodvessels血管异常Swelling,bloodorfattydepositsintheretina视网膜上的肿胀、血液或脂肪沉积Damagetothenervetissue对神经组织的损伤Growthofnewbloodvesselsandscartissue新生血管和瘢痕组织的生长Bleedinginthevitreous玻璃体出血Retinaldetachment视网膜脱离TestsanddiagnosisAspartoftheeyeexam,yourdoctormaydoaretinalphotographytestcalledfluoresceinangiography.Yourdoctoralsomayrequestanopticalcoherencetomography(OCT)exam.作为眼科检查的一部分，你的医生可能会做一个叫做荧光血管造影的视网膜摄影检查。你的医生也可能要求光学相干断层扫描检查。TreatmentsTreatmentfordiabeticretinopathydependsonthetypeofdiabeticretinopathyyouhave,itsseverityandhowwellitmayrespondtospecifictreatments.糖尿病视网膜病变的治疗取决于糖尿病视网膜病变的类型，其严重程度以及它对特定治疗的反应程度。Earlydiabeticretinopathy

早期糖尿病视网膜病变

Ifyouhavenonproliferativediabeticretinopathy,youmaynotneedtreatmentrightaway.However,youreyedoctorwillcloselymonitoryourretinatodetermineifyouneedlasertreatment.如果你有非增殖性糖尿病视网膜病变，你可能不需要马上治疗。然而，你的眼睛医生会密切监测你的视网膜，以确定是否需要激光治疗。Advanceddiabeticretinopathy

晚期糖尿病视网膜病变Ifyouhaveproliferativediabeticretinopathy,you'llneedpromptsurgicaltreatment.Sometimessurgeryisrecommendedforseverenonproliferativediabeticretinopathy,too.Dependingonthespecificproblemswithyourretina,optionsmayinclude:如果你有增生性糖尿病视网膜病变，你需要及时手术治疗。有时手术被推荐用于重度非增殖性糖尿病视网膜病变。根据您的视网膜上的具体问题，选项可能包括：Treatmentsanddrugslasertreatmentsurgicaltreatment.Virtectomy激光治疗外科治疗。玻璃体手术PreventionRemember,diabetesdoesn'tnecessarilydoomyoutopoorvision.Takinganactiveroleindiabetesmanagementcangoalongwaytowardp