Causes of Diabetic Retinopathy
List of causes of Diabetic Retinopathy
Following is a list of causes or underlying conditions
(see also Misdiagnosis of underlying causes of Diabetic Retinopathy)
that could possibly cause Diabetic Retinopathy includes:
More causes:
see full list of causes for Diabetic retinopathy
Causes of Diabetic Retinopathy (Diseases Database):
The follow list shows some of the possible medical causes of Diabetic Retinopathy
that are listed by the Diseases Database:
Source: Diseases Database
Diabetic Retinopathy Causes: Book Excerpts
Diabetic Retinopathy as a complication of other conditions:
Other conditions that might have
Diabetic Retinopathy as a complication may,
potentially, be an underlying cause of Diabetic Retinopathy.
Our database lists the following as having
Diabetic Retinopathy as a complication of that condition:
Diabetic Retinopathy as a symptom:
Conditions listing Diabetic Retinopathy
as a symptom may also be potential underlying causes of Diabetic Retinopathy.
Our database lists the following as having
Diabetic Retinopathy as a symptom of that condition:
What causes Diabetic Retinopathy?
Causes: Diabetic Retinopathy:
Diabetic sugar levels damage eye blood vessels.
Article excerpts about the
causes of Diabetic Retinopathy:
Keep your eyes healthy: NIDDK (Excerpt)
As diabetes retina problems get worse, new blood vessels grow. These
new blood vessels are weak. They break easily and leak blood into the
vitreous of your eye. The leaking blood keeps light from reaching the
retina.
You may see floating spots or almost total darkness. Sometimes the
blood will clear out by itself. But you might need surgery to remove it.
Over the years, the swollen and weak blood vessels can form scar tissue
and pull the retina away from the back of the eye. If the retina becomes
detached, you may see floating spots or flashing lights.
You may feel as if a curtain has been pulled over part of what you are
looking at. A detached retina can cause loss of sight or blindness if you
don't take care of it right away. (Source: excerpt from Keep your eyes healthy: NIDDK)
Are You at Risk for Diabetic Eye Disease: NEI (Excerpt)
It is caused by changes in the blood
vessels of the retina. In some people with diabetic retinopathy,
retinal blood vessels may swell and leak fluid. In other people,
abnormal new blood vessels grow on the surface of the retina. These
changes may result in vision loss or blindness. (Source: excerpt from Are You at Risk for Diabetic Eye Disease: NEI)
Medical news summaries relating to Diabetic Retinopathy:
The following medical news items are relevant to causes of Diabetic Retinopathy:
Related information on causes of Diabetic Retinopathy:
As with all medical conditions,
there may be many causal factors.
Further relevant information on causes of Diabetic Retinopathy may be found in:
Causes of Diabetic Retinopathy: Online Medical Books
16 MEDICAL BOOKS ONLINE!
Review excerpts from medical books online, free, without registration,
for more information about the causes of Diabetic Retinopathy.
Retinal Hemorrhage:
Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)
-
It is critical to realize that hemorrhages do not progress but represent altered structure, and as such may affect acuity
-
Nonaccidental trauma must be the first etiology considered
-
Pigmented lesions of the retina including choroidal nevi, congenital hypertrophy of the retinal pigment epithelium, retinal pigment epithelial hyperplasia
-
Diabetic retinopathy is characterized by dot/blot, flame, preretinal, vitreous hemorrhages
-
Hypertensive retinopathy is typically accompanied by signs of hypoxia, e.g., cotton wool spots and optic disc swelling
-
May be associated with any systemic vascular disease or collagen vascular disease (e.g., systemic lupus erythematosus)
-
Vein occlusion
–Occlusion of a central vein may involve the entire retina, occlusion of one branch vein involves a section of the retina
-
Peripheral retinal hemorrhaging may be associated with vascular insufficiency due to carotid stenosis
-
May be associated with optic disc swelling
-
Traumatic truncal injury may create intraretinal hemorrhages called Purtscher lesions
-
Intracranial hemorrhage may dissect forward to surround optic nerve (Terson phenomenon)
-
Blood dyscrasias, anemias, leukemias, sickle cell, ocular sarcoidosis, Behçet disease, Eales disease may cause retinopathy
-
If sudden loss of vision is associated, wet macular degeneration, macular hemorrhage of histoplasmosis, preretinal hemorrhage, or vitreous hemorrhage may be the etiology
-
Retinal vascular tumors, which may have an associated neurologic aneurysm
-
HIV retinopathy presents with hemorrhage as first sign but may progress to involve and destroy vision
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Retinal detachment:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
Any retinal tear or hole allows the liquid vitreous to seep between the retinal layers, separating the retina from its choroidal blood supply. Predisposing factors include myopia, intraocular surgery, and trauma. In adults, retinal detachment usually results from degenerative changes of aging, which cause a spontaneous retinal hole. Perhaps the influence of trauma explains why retinal detachment is twice as common in males. Retinal detachment may also result from seepage of fluid into the subretinal space (because of inflammation, tumors, or systemic diseases) or from traction that’s placed on the retina by vitreous bands or membranes (due to proliferative diabetic retinopathy, posterior uveitis, or a traumatic intraocular foreign body).
Retinal detachment is rare in children, but occasionally can develop as a result of retinopathy of prematurity, tumors (retinoblastomas), trauma, or myopia (which tends to run in families).
In the United States, approximately 10,000 people per year are affected by retinal detachments.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Vascular retinopathies:
Causes and incidence
(Professional Guide to Diseases (Eighth Edition))
When one of the arteries maintaining blood circulation in the retina becomes obstructed, the diminished blood flow causes visual deficits. (See Anatomy of vascular retinopathy.)
Central retinal artery occlusion may be idiopathic or may result from embolism, atherosclerosis, infection, or conditions that retard blood flow, such as temporal arteritis, carotid occlusion, and heart failure. This occlusion is rare, occurs unilaterally, and usually affects elderly patients. However, if it occurs in a younger person, the obstruction may have originated in the heart (such as embolization from plaque material from valve vegetations) and should be investigated accordingly.
Causes of central retinal vein occlusion include atherosclerosis, hypertension, optic disk edema, hypercoagulable states (polycythemia, leukemia, or sickle cell disease), glaucoma, retrobulbar compression (such as an orbital tumor), and drugs such as hormonal contraceptives. This form of vascular retinopathy is most prevalent in elderly patients and is characterized by impaired venous outflow.
Diabetic retinopathy results from juvenile or adult diabetes. Microcirculatory changes occur more rapidly when diabetes is poorly controlled. About 90% of patients with juvenile diabetes develop retinopathy within 20 years of onset of diabetes. In adults with diabetes, incidence increases with the duration of diabetes; 80% of patients who have had diabetes for 20 to 25 years develop retinopathy. This condition is a leading cause of acquired adult blindness.
Hypertensive retinopathy results from prolonged hypertensive disease, producing retinal vasospasm, and consequent damage and arteriolar narrowing.
Sickle cell retinopathy results from impaired ability of the sickled cell to pass through microvasculature, producing vaso-occlusion. This leads to microaneurysms, chorioretinal infarction, and retinal detachment.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Retinal Phenomena:
Differential Overview
(Field Guide to Bedside Diagnosis)
❑ Hypertension
❑ Diabetic retinopathy
❑ Glaucoma
❑ Cholesterol emboli
❑ Papilledema
❑ Pigmented crescent
❑ Macular degeneration
❑ Retinal detachment
❑ Acute optic neuritis
❑ Optic atrophy
❑ Retinal hemorrhage
❑ Chorioretinal exudates
❑ Lipemia retinalis
❑ Central retinal artery occlusion
❑ Central retinal vein occlusion
❑ Angioid streaks
❑ Hyperviscosity
Clinical Findings
Hypertension A significant AV crossing change is one that is two disc diameters out and that obliterates the venous column of blood. This is because of longstanding arterial muscular hypertrophy, and it will remain even after the hypertension is treated. Accelerated hypertension is most readily recognized by retinal hemorrhage, which is a marker for a similar pathophysiology in the brain.
Diabetic retinopathy Diabetic retinopathy most often involves microaneurysms, dot hemorrhages, and exudates. Neovascularization around the optic disc heralds retinal and vitreous hemorrhage, which leads to blindness.
Glaucoma The optic cup-to-disc ratio is increased, and striations can be seen on the surface of the cup. The cup is several diopters deep, with vessels visibly rising over the lip of the disc.
Cholesterol emboli A brightly refractile yellow embolus impacts at an arteriolar branch point. This is important to recognize as a marker of an ulcerated carotid plaque.
Papilledema The optic disc becomes edematous, which is manifest as an indistinct disc margin, hyperemia, and absence of venous pulsations. The usual implication is raised intracranial pressure.
Pigmented crescent This is a normal finding adjacent to the disc, and its appearance corresponds to the degree of skin pigmentation.
Macular degeneration Macular drusen, atrophy of the retinal pigment with prominent choroidal vessels, subretinal edema or hemorrhage, and a central fibrous scar are typical findings.
Retinal detachment The retina appears to billow in undulating folds. It is difficult to keep vessels in focus because they cross focal planes.
Acute optic neuritis On examination it appears very similar to papilledema, but there is decreased visual acuity as opposed to an enlarged physiologic blind spot.
Optic atrophy It appears as a porcelain-white disc with sharply demarcated edges.
Retinal hemorrhage Retinal hemorrhage is found in accelerated hypertension, diabetes, pernicious anemia, DIC, leukemia, and subarachnoid hemorrhage. In endocarditis, a Roth spot (focal hemorrhage with a clear center) may be found.
Chorioretinal exudates Cytomegalovirus retinitis in a patient with AIDS has an appearance of a yellow granular exudate with hemorrhage at the advancing border. These should be distinguished from the cotton-wool spots caused by HIV infection alone. White cotton-like lesions in a febrile immunocompromised patient suggest systemic candidiasis.
Lipemia retinalis The retina and retinal vessels have a pale yellow appearance in hypertriglyceridemia.
Central retinal artery occlusion The optic disc is pale, the retina is edematous, the macula appears cherry-red, and there are “boxcar veins.”
Central retinal vein occlusion Veins are tortuous and dilated, the retina is edematous and has flame hemorrhages, and the optic disc margin is blurred.
Angioid streaks Dark linear streaking of the retina in pseudoxanthoma elasticum appears like ghosts of traversing vessels. This condition is associated with accelerated peripheral vascular and coronary artery disease.
Hyperviscosity Tortuous sausage-link retinal veins are found in
macroglobulinemia.
» READ BOOK EXCERPT ONLINE »
Source: Field Guide to Bedside Diagnosis, 2007
Retinal detachment:
Causes
(Handbook of Diseases)
Any retinal tear or hole allows the liquid vitreous to seep between the retinal layers, separating the retina from its choroidal blood supply. In adults, retinal detachment usually results from degenerative changes of aging, which cause a spontaneous retinal hole.
Predisposing factors include myopia, cataract surgery, and trauma. Perhaps the influence of trauma explains why retinal detachment is twice as common in males.
Retinal detachment may also result from seepage of fluid into the subretinal space (because of inflammation, tumors, or systemic diseases) or from traction that’s placed on the retina by vitreous bands or membranes (from proliferative diabetic retinopathy, posterior uveitis, or a traumatic intraocular foreign body).
Retinal detachment is rare in children but occasionally can develop as a result of retinopathy of prematurity, tumors (retinoblastomas), or trauma. It can also be inherited, usually in association with myopia.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
Vascular retinopathies:
Causes
(Handbook of Diseases)
When one of the arteries maintaining blood circulation in the retina becomes obstructed, the diminished blood flow causes visual deficits.
Central retinal artery occlusion
This form of vascular retinopathy may be idiopathic or may result from embolism, atherosclerosis, infection, or conditions that retard blood flow, such as carotid occlusion and heart valve vegetations. Central retinal artery occlusion is rare and occurs unilaterally; it affects elderly patients as well as younger patients with valvular disease.
Central retinal vein occlusion
Causes of central retinal vein occlusion include external compression of the retinal vein, trauma, diabetes, thrombosis, granulomatous diseases, generalized and localized infections, glaucoma, and atherosclerosis. This form of vascular retinopathy is most prevalent in elderly patients.
Diabetic retinopathy
This form results from juvenile or adult diabetes. Microcirculatory changes occur more rapidly when diabetes is poorly controlled. About 75% of patients with juvenile diabetes develop retinopathy within 20 years of onset of diabetes.
In adults with diabetes, incidence increases with the duration of diabetes; 80% of patients who have had diabetes for 20 to 25 years develop retinopathy. This condition is a leading cause of acquired adult blindness.
Hypertensive retinopathy
This form results from prolonged hypertensive disease, producing retinal vasospasm, and consequent damage and arteriolar narrowing.
Sickle cell retinopathy
This form results from impaired ability of the sickled cell to pass through the microvasculature, producing vasocclusion. This results in microaneurysms, chorioretinal infarction, and retinal detachment.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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