糖尿病视网膜病变：首选临床实践模式

Diabetic retinopathy is a disorder of the retina that eventually develops to some degree in nearly all patients with long-standing diabetes mellitus. While defects in neurosensory function have been demonstrated in patients with diabetes mellitus prior to the onset of vascular lesions, the earliest visible clinical manifestations of retinopathy include microaneurysms and hemorrhages. Vascular alterations can progress to retinal capillary nonperfusion, resulting in a clinical picture characterized by increased numbers of hemorrhages, venous abnormalities, and intraretinal microvascular abnormalities (IRMA). A later stage includes closure of arterioles and venules and proliferation of new vessels on the disc, retina, iris, and filtration angle. Increased vasopermeability results in retinal thickening (edema) during the course of diabetic retinopathy. Visual loss results mainly from macular edema, macular capillary nonperfusion, vitreous hemorrhage, and distortion or traction detachment of the retina.

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