Impact and association of vision impairment from diabetic retinopathy in diabetic patients - Thesis Example

Diabetic retinopathy remains one of the most common complications of diabetes (Diabetic Retinopathy, Facts about Diabetic Retinopathy, .Due to a continuous increase in the prevalence of diabetes globally, the chances of development of diabetic retinopathy, along with other diabetic eye complications are also raising (Zimmet et al, 2005, International Diabetes Federation, 2006). Diabetic retinoathy has very strong economical, social and psychological effects on the patient as well as the families of the patients (The Economic Impact of Vision Problems, 2007, pp 6).

Diabetic retinopathy remains one of the top four reasons of loss of sight, and puts a financial burden of over $25 billion per annum, along with other main causes of blindness (The Economic Impact of Vision Problems, 2007, pp 6). Another cause of concern is the increase of the disease among younger age groups, ranging from ages 18 to 69 years, making it a possible leading cause of eye and vision loss at early ages (Teck, 2006). Diabetic retinopathy is one of the reliable tools to assess the status, rate of progress and complications developing in the patient with the disease.

Therefore, it can be used for systematic evaluation and checkups to ascertain the efficacy of a certain treatment regarding management of diabetes (Chun et al, 2007). American researches claim diabetic retinopathy to be the leading cause of blindness among people younger than 65 years of age (Knobbe and Hadrill, 2011). Alongside, researches on Australian and American populations also suggest that diabetic retinopathy is associated with higher risks of mortality due to heart complications and stroke respectively (Wu, 2010, pp 263).

Diabetes can lead to many types of eye complications, including glaucoma, or the increase in the intraocular pressure, which in turn may increase chances of developing diabetic retinopathy (Sugiura et al, 2011, pp 624 and 625). Again, the type of retinopathy affects the intraocular pressure. Proliferative retinopathy demonstrates lower intraocular pressures when compared to the non proliferative type. Most of the time, the eyes are affected equally, meaning that the chances of blindness due to complications are likely to take place in both eyes (Scanlon et al, 2009, pp 111).

The type I patients are likely to see more severe form of the condition along with the proliferative type of retinopathy (Scanlon et al, 2009, pp 112). There are both systemic as well as local factors that influence the development and progression of diabetic retinopathy. The most important systematic factor is the glycemic control itself. Although retinopathy can occur in patients without the clinical presence of diabetes among people of ages above 40, researches still show a strong correlation between the lack of glycemic control and increase in diabetic retinopathy.

An irregular followup or following up on the treatment regime may also promote diabetic retinopathy (Scanlon et al, 2009, pp 112). However, strict glycemic control provides reduction of retinopathy incidence in the long term. Local factors are just as important in the development of diabetic retinopathy as systematic factors. The blood vessels in the retina are regulated by local factors such as the Endothelin I, angiotensin II, hyperoxia, carbondioxide, nitric oxide and adenosine respectively (Yanoff and Duker, 2008, pp 520).

Local blood factors can cause endothelial damage to the vessels due to increased platelet aggregation and adherence, leukostasis, increased activity and adhesion of the leucocytes, decreased deformability and increased aggregation of the red blood cells, and the degradation of the extracellular matrix of the endothelial cells respectively (Yanoff and Duker, 2008, pp 205). Current research trends are aimed at the efficacy and utilization of laser photocoagulation in diabetic retinopathy (Donelly and Horton, 2005, pp 167).

The use of VPF releasing mechanisms is also under research, for their prevention in the ischaemia induced formation of growth factors (Donelly and Horton, 2005, pp 168). However, concerns such as macular edema, retinal hemorrhage, suprachoroidal effusion and uveitis etc. are some of the chief complications of such treatments, which need to be, addressed appropriately (Donelly and Horton, 2005, pp 168). REFERENCES Browing David J, 2010. Diabetic Retinopathy: Evidence Based Management. Springer, 2010.

Chun DW, Bauer RM, Ward TP, Dick JS2nd, Bower KS, 2007. Evaluation of Digital Fundus Images as a Diagnostic Method for Surveillance of Diabetic Retinopathy. Mil Med 2007 Apr; 172(4): 405-410. Diabetic Retinopathy, 2011. Patient.co.uk. Site last accessed on March 20th, 2011 from http://www.patient.co.uk/health/Diabetes-Diabetic-Retinopathy.htm The Economic Impact of Vision Problems, 2007. Report by Prevent Blindness America. Site last accessed on March 10th, 2011 from http://www.preventblindness.

org/research/Impact_of_Vision_Problems.pdf Facts About Diabetic Retinopathy, 2011. National Eye Institute. Site last accessed on March 20th, 2011 from http://www.nei.nih.gov/health/diabetic/retinopathy.asp Knobbe Chris A and Haddrill M, 2011. Diabetic Retinopathys. Site last accessed on March 2011 from http://www.allaboutvision.com/conditions/diabetic.htm Scanlon P, Wilkinson C, Aldington S, Matthews D, 2009. A Practice Manual of Diabetic Retinopathy Management. John Wiley and Son. Sugiura Y, Okamoto F, Okamoto Y, Hasegawa Y, Hiraoka T and Oshika T, 2011.

Ophthalmodynamometric Pressure in Eyes With Proliferative Diabetic Retinopathy Measured During Pars Plana Vitrectomy, 2011. American Journal of Ophthalmology Vol 151, Issue 4, pp 624-629. Teck Yeo Kim, 2006. The Global Need for Screening in Diabetic Retinopathy and the Singapore Experience. Special Feature. Site last accessed on March 23rd, 2011 from http://www.diabetes.org.sg/resources/jan08-24-26.pdf Wu, Gloria, 2010. Diabetic Retinopathy: The Essentials. Lippincott Williams and Wilkins. Yanoff M and Duker JS, 2008.

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