IMPROVEMENT OF METHODS OF DIAGNOSTIC AND TREATMENT OF DIABETIC RETINOPATHY

Аннотация

Diabetic retinopathy - complications lead to damage to retinal vessels and the development of microaneurysms, as well as the proliferation of newly formed vessels in the fundus of the eye. The problem of early diagnosis and treatment of diabetic retinopathy remains one of the urgent problems of modern ophthalmology, which is associated with the late presentation of patients with diabetic retinopathy. Keywords: diabetes mellitus, diabetic retinopathy, fundus of the eye. СОВЕРШЕНСТВОВАНИЕ МЕТОДОВ ДИАГНОСТИКИ И ЛЕЧЕНИЯ ДИАБЕТИЧЕСКОЙ РЕТИНОПАТИИ Аннотация. Диабетическая ретинопатия - осложнения приводят к поражению сосудов сетчатки и развитию микроаневризм, а также пролиферации новообразованных сосудов на глазном дне. Проблема ранней диагностики и лечения диабетической ретинопатии остается одной из актуальных проблем современной офтальмологии, что связано с поздним обращением пациентов с диабетической ретинопатией. Ключевые слова: сахарный диабет, диабетическая ретинопатия, глазное дно. Prevention of diabetic retinopathy is one of the urgent problems of domestic and foreign healthcare, which is accompanied by a constant increase in the prevalence of diabetes mellitus among the population, which ultimately leads to vision loss and social deprivation. The social importance and relevance of the problem of early diagnosis of diabetic retinopathy (DR) is to prevent disability and blindness in people of working age with diabetes and improve their quality of life. As a result of studying the prevalence of DR among the population of developing countries, it was shown that the prevalence of DR in people with known diabetes mellitus ranges from 10% to 61% and in newly diagnosed diabetes from 1.5 to 31%. A comparative analysis of the prevalence of diabetic maculopathy (DM) and DR in the UK from 2007 to 2010. It was shown that there were 76,127 patients with DM with non-proliferative DR in 59.6-67.3% of cases and proliferative DR in 18.3-20.9%. Clinically significant macular edema was present in 15.8-18.1% of cases. Currently, there are 5 million blind people and 180 million visually impaired people in the world. It is estimated that by 2030 the number of blind people will increase by 27%, and the number of people with low vision by 45%. 1930 ResearchBib IF - 11.01, ISSN: 3030-3753, Volume 2 Issue 4 Diabetic retinopathy (DR) was first described 100 years ago in 1879 by Kenzi.M, but even today this complication of diabetes is a major health problem. Despite the widespread introduction of new effective drugs and instrumental methods for diagnosis and treatment, DR still remains the main cause of vision loss. Different figures are given for the prevalence of DR in type 1 and type 2 diabetes mellitus in different countries. In patients with undiagnosed type 2 diabetes, symptoms of DR are detected at the time of diagnosis in 7-30% of patients. Moreover, unlike DM, proliferative DR is not a major problem for them, while diabetic maculopathy is the main cause of visual acuity deterioration. The age of patients with diabetes mellitus (DM) can be considered as a risk factor. It is known that DR is extremely rare in childhood. However, with the onset of puberty, microvascular complications, including the rapid development of diabetic retinopathy, are observed. This is due to the fact that during this period a strong hormonal restructuring occurs, which is accompanied by the production of a large number of counterinsulin factors - tropic hormones of the pituitary gland, sex steroids, growth factors. The decompensation of DM that develops in this case can be explained by a rapid increase in body weight and, as a result, an increase in the need for insulin. The period of puberty is considered the most dangerous in terms of the development of DR. It should be remembered that the organization of a clear system of detection and treatment of diabetic retinopathy should lead to a reduction in the risk of blindness, which, among other things, is manifested in a significant economic effect. Suffice it to say that the annual costs of treating one patient with diabetic retinopathy (laser) are almost 12 times less than state social costs (pensions). Thus, the organization of an affordable system of treatment of retinopathy by laser methods will be economically beneficial, taking into account the material costs of paying disability benefits paid by the state, as well as direct losses due to the inability to participate in the production of a large number of people of working age who have low vision and are blind due to diabetic retinopathy. Of course, in material terms it is impossible to take into account the moral losses from human suffering. However, it should be noted that there are various potential obstacles to the prevention of complications of diabetes. Thus, according to WHO, the main obstacles to the highly effective prevention of blindness due to diabetic retinopathy are: - lack of information about diabetic retinopathy and its consequ