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Diabetesretinopati

Senast reviderad:
Sakkunnig:
Definition:
Retinopati till följd av progressiv mikroangiopati orsakat av typ 1- eller typ 2-diabetes.
Förekomst:
Globalt hade 35 % av personer med diabetes diabetesretinopati och 10 % så allvarlig diabetesretinopati att den hotade synen i en metaanalys från 2012. Förekomsten av allvarlig retinopati är lägre i länder som Sverige på grund av välfungerade diabetesvård.
Symtom:
Få symtom tidigt i förloppet eftersom förändringarna ofta börjar perifert i retina.
Kliniska fynd:
Retinala förändringar i form av mikroaneurysm, små blödningar och exsudat. Svullnad i gula fläcken med synnedsättning kan förekomma, liksom utveckling av proliferativa kärl med ökad risk för glaskroppsblödning och näthinneavlossning. Utveckling av katarakt kan ske tidigare än hos personer utan diabetes.
Diagnostik:
Rutinmässig screening hos ögonläkare.
Behandling:
Primärt bästa möjliga metabola kontroll (blodsocker, blodtryck, blodfetter, rökstopp). Sekundärt laserfotokoagulation, eventuellt behandling med intravitreala injektioner av anti-VEGF.
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  • Anders Behndig, professor och överläkare, Ögonkliniken, Norrlands universitetssjukhus, Umeå
  • Anna Nager, docent och specialist i allmänmedicin, Karolinska institutet