15. Frank RN: Etiologic mechanisms in diabetic retinopathy. In Ryan SJ, ed: Retina, Schachat AP and Murphy RP, eds vol. 2 Medical Retina,, St. Louis, 1994, Mosby, p. 1263 Damien Luviano, MD, FACS
31. Indications for treatment of proliferative diabetic retinopathy NVD > 1/3 disc in area Less extensive NVD + haemorrhage NVE > 1/2 disc in area + haemorrhage Damien Luviano, MD, FACS
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37. Indications for vitreoretinal surgery Retinal detachment involving macula Severe persistent vitreous haemorrhage Dense, persistent premacular haemorrhage Progressive proliferation despite laser therapy Damien Luviano, MD, FACS
Infections: pneumonia, flu, death Dental disease Almost one-third severe periodontal diseases Complications of pregnancy major birth defects excessively large babies Nervous system disease About 60% to 70% mild to severe forms of nervous system damage Amputations More than 60% of nontraumatic lower-limb amputations. In 2000-2001, about 82,000 lower-limb amputations on DM Heart disease and stroke leading cause of diabetes-related deaths. High blood pressure 73% of adults with diabetes have blood pressure
Infections: pneumonia, flu, death Dental disease Almost one-third severe periodontal diseases Complications of pregnancy major birth defects excessively large babies Nervous system disease About 60% to 70% mild to severe forms of nervous system damage Amputations More than 60% of nontraumatic lower-limb amputations. In 2000-2001, about 82,000 lower-limb amputations on DM Heart disease and stroke leading cause of diabetes-related deaths. High blood pressure 73% of adults with diabetes have blood pressure
Infections: pneumonia, flu, death Dental disease Almost one-third severe periodontal diseases Complications of pregnancy major birth defects excessively large babies Nervous system disease About 60% to 70% mild to severe forms of nervous system damage Amputations More than 60% of nontraumatic lower-limb amputations. In 2000-2001, about 82,000 lower-limb amputations on DM Heart disease and stroke leading cause of diabetes-related deaths. High blood pressure 73% of adults with diabetes have blood pressure
Infections: pneumonia, flu, death Dental disease Almost one-third severe periodontal diseases Complications of pregnancy major birth defects excessively large babies Nervous system disease About 60% to 70% mild to severe forms of nervous system damage Amputations More than 60% of nontraumatic lower-limb amputations. In 2000-2001, about 82,000 lower-limb amputations on DM Heart disease and stroke leading cause of diabetes-related deaths. High blood pressure 73% of adults with diabetes have blood pressure
Diabetes mellitus (DM) major medical problem throughout the world. Diabetes causes wide array of long-term systemic complications considerable impact the patient and the society
Diabetic retinopathy causes 12,000 to 24,000 new cases of blindness each year.
Familial clustering Mutation of aldose reductase gene Increased risk of nephropathy (Type I) Heesom, et al, 1997 Earlier onset of diabetic retinopathy (Type II) Ko, et al, 1995
Opening of tight junctions between endothelial cells Endothelial cell fenestration RPE plasma membrane infoldings Endocytic vesicle transport
Total prevalence of diabetes among people aged 20 years or older, United States, 2002 Age 20 years or older: 18.0 million; 8.7% of all people in this age group have diabetes. Age 60 years or older: 8.6 million; 18.3% of all people in this age group have diabetes. Men: 8.7 million; 8.7% of all men aged 20 years or older have diabetes. Women: 9.3 million; 8.7% of all women aged 20 years or older have diabetes.