| Abstract [eng] |
Diabetic retinopathy is a chronic complication of diabetes mellitus that damages the blood vessels in the retina, causing vision impairment or blindness. It is a disease that can be asymptomatic for a long time and is often only detected in its advanced stages. Young adults, who most often suffer from type 1 diabetes, are at a higher risk due to the longer duration of the disease. Diabetic retinopathy is characterised by microaneurysms, capillary occlusions, retinal ischaemia, neovascularisation and may progress to diabetic macular oedema. In addition to vascular lesions, retinal neuronal and glial lesions have been shown to play an important role in the pathogenesis of diabetic retinopathy, and may be present before the appearance of visible vascular lesions. Modern invasive and non-invasive tests such as optical coherence tomography, fluorescein angiography, optical coherence tomography angiography as well as the increasing application of artificial intelligence technologies are being used to confirm the diagnosis and to monitor the disease. Treatment tactics depend on the stage of the disease: the aim is to control systemic risk factors such as hyperglycaemia in the early stages and as the disease progresses, laser photocoagulation procedures, injections of vascular endothelial growth factor inhibitors or corticosteroids are used. The aim of this paper is to describe the course, diagnosis and treatment of diabetic retinopathy in young adults, based on the literature and a clinical example. In this paper a case of a 34-year-old female patient with type 1 diabetes mellitus is presented. After prolonged hyperglycaemia, her glycaemic control improved significantly with insulin pump therapy. Nevertheless, the patient experienced progression of diabetic retinopathy to the proliferative stage with centrally involved diabetic macular oedema. |
