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 Printable version |
Diabete maculopathy |
Sang Thrombose Vaisseaux. Volume 17, Number 8, 417-25, Octobre 2005, Mini-revue
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 Résumé
Article gratuit
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Author(s) : John Conrath, Amélie Lecleire-Collet, Ali Erginay, Pascale Massin |
Summary : The retinal involvment of the posterior pole of the eye secondary to diabetes is termed diabetic maculopathy, which may be either ischemic or edemetous, or both. Macular edema is the major cause of impaired vision in type 2 diabetes. Its pathophysiology is complex, due to chronic hyperglycemia and resulting in extracellular edema. Diagnosis of macular edema requires careful examination of the ocular fundus, using slit lamp biomicroscopy. Recently, optical coherence tomography has revolutionized the diagnosis and surveillance of macular edema, permitting anatomical views of the macular retina. Fluorescein angiography is not necessary, but allows visualization of the vascular abnormalites which are at the origin of the edema. The functional alterations secondary to macular edema are variable, but its chronic evolution usually causes major visual loss. Reference treatment of macular edema is laser photocoagulation of the thickened retina and/or the lesions causing edema. The goal is to stabilize vision by reducing macular thickness. New treatments (intraocular triamcinolone injections, anti-VEGF injections and vitreo-retinal surgery) are currently being evaluated. Ischemic maculopathy is defined by enlargement of the foveal avascular zone of the retina which usually measures 600 μm in diameter. It enlarges secondary to capillary occlusion. Visual acuity usually decreases when its diameter doubles. There is no specific therapy for macular ischemia to date. |
Keywords : diabetes, diabetic retinopathy, diabetic maculopathy, macular edema, macular ischemia, laser, triamcinolone, vitrectomy |
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