Retinopathy
| Retinopathy | |
|---|---|
| Specialty | Ophthalmology  |
Retinopathy is persistent or acute damage to the retina of the eye. Ongoing inflammation and vascular remodeling may occur over periods of time where the patient is not fully aware of the extent of the disease. Frequently, retinopathy is an ocular manifestation of systemic disease as seen in diabetes or hypertension.[1] Diabetic retinopathy is the leading cause of blindness in working-aged people.[2]
Pathophysiology
Causes of retinopathy include but are not limited to:
- Diabetes mellitus, which causes diabetic retinopathy
- Arterial hypertension, which causes hypertensive retinopathy
- Retinopathy of prematurity due to prematurity of the newborn (under the 9 months of human pregnancy).
- Radiation retinopathy due to exposure to ionizing radiation.
- Solar retinopathy due to direct sunlight exposure.
- Sickle cell disease
- Retinal vascular disease such as retinal vein or artery occlusion.
- Trauma, especially to the head, and several diseases may cause Purtscher's retinopathy
- Hyperviscosity-related retinopathy as seen in disorders which cause paraproteinemia
Many types of retinopathy are proliferative, most often resulting from neovascularization or blood vessel overgrowth. Angiogenesis is the hallmark precursor that may result in blindness or severe vision loss, particularly if the macula becomes affected.[1]
Retinopathy may more rarely be due to ciliopathic genetic disorders, such as Alström syndrome or Bardet–Biedl syndrome.[3]
Retinopathy is diagnosed by an ophthalmologist during eye examination. Treatment depends on the cause of the disease.
Remote screening
Telemedicine programs are available that allow primary care clinics to take images using specially designed retinal imaging equipment which can then be shared electronically with specialists at other locations for review.[4] In 2009, Community Health Center, Inc. implemented a telemedicine retinal screening program for low-income patients with diabetes as part of those patients annual visits at the Federally Qualified Health Center.[5]
Treatment
Treatment is based on the cause of the retinopathy and may include laser therapy to the retina. In recent years targeting the pathway controlling vessel growth or angiogenesis has been promising. Vascular endothelial growth factor (VEGF) seems to play a vital role in promoting neovascularization. Using anti-VEGF drugs (antibodies to sequester the growth factor), researches have shown significant reduction in the extent of vessel outgrowth. Several anti-VEGF treatments are currently under review in both clinical trials and in preclinical labs.[1]
See also
References
- ^ a b c American Academy of Ophthalmology (2012). Retina and vitreous (2011-2012 ed.). p. 271. ISBN 9781615251193.
- ^ Cheung, Ning (June 26, 2010). "Diabetic retinopathy". doi:10.1016/S0140.
{{cite journal}}: Cite journal requires|journal=(help) - ^ Badano JL, Mitsuma N, Beales PL, Katsanis N (2006). "The ciliopathies: an emerging class of human genetic disorders". Annu Rev Genomics Hum Genet. 7: 125–48. doi:10.1146/annurev.genom.7.080505.115610. PMID 16722803.
- ^ "Remote Retinal Screening Facilitates Diagnosis and Treatment of Retinopathy for Poor and/or Uninsured Patients With Diabetes in Rural California". Agency for Healthcare Research and Quality. 2013-10-03. Retrieved 2013-08-01.
- ^ "Telemedicine-Based Eye Examinations Enhance Access, Reduce Costs, and Increase Satisfaction for Low-Income and Minority Patients with Diabetes". Agency for Healthcare Research and Quality. 2013-07-17. Retrieved 2013-08-01.