Retinopathy in the context of Macular degeneration


Retinopathy in the context of Macular degeneration

⭐ Core Definition: Retinopathy

Retinopathy is any damage to the retina of the eyes, which may cause vision impairment. Retinopathy often refers to retinal vascular disease, or damage to the retina caused by abnormal blood flow. Age-related macular degeneration is technically included under the umbrella term retinopathy but is often discussed as a separate entity. Retinopathy, or retinal vascular disease, can be broadly categorized into proliferative and non-proliferative types. Frequently, retinopathy is an ocular manifestation of systemic disease as seen in diabetes or hypertension. Diabetes is the most common cause of retinopathy in the U.S. as of 2008. Diabetic retinopathy is the leading cause of blindness in working-aged people. It accounts for about 5% of blindness worldwide and is designated a priority eye disease by the World Health Organization.

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Retinopathy in the context of Diabetic retinopathy

Diabetic retinopathy (also known as diabetic eye disease) is a medical condition in which damage occurs to the retina due to diabetes. It is a leading cause of blindness in developed countries and one of the leading causes of sight loss in the world, even though there are many new therapies and improved treatments for helping people living with diabetes.

Diabetic retinopathy affects up to 80 percent of those who have had both type 1 and type 2 diabetes for 20 years or more. In at least 90% of new cases, progression to more aggressive forms of sight-threatening retinopathy and maculopathy could be reduced with proper treatment and monitoring of the eyes. The longer a person has diabetes, the higher their chances of developing diabetic retinopathy. Each year in the United States, diabetic retinopathy accounts for 12% of all new cases of blindness. It is also the leading cause of blindness in people aged 20 to 64.

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Retinopathy in the context of Blurred vision

Blurred vision is an ocular symptom where vision becomes less precise and there is added difficulty to resolve fine details.

Temporary blurred vision may involve dry eyes, eye infections, alcohol poisoning, hypoglycemia, or low blood pressure. Other medical conditions may include refractive errors such as myopia, high hypermetropia, and astigmatism, amblyopia, presbyopia, pseudomyopia, diabetes, cataract, pernicious anemia, vitamin B12 deficiency, thiamine deficiency, glaucoma, retinopathy, hypervitaminosis A, migraine, sjögren's syndrome, floater, macular degeneration, and can be a sign of stroke or brain tumor.

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Retinopathy in the context of Vitamin E deficiency

Vitamin E deficiency is a rare condition caused by low levels of vitamin E that may result from malabsorption disorders (such as abetalipoproteinemia, cystic fibrosis, or Crohn's disease), or impaired lipid transport. As a potent antioxidant, vitamin E protects cell membranes from oxidative damage, and its deficiency primarily affects tissues with high fatty acid content, especially the nervous system. Clinically, patients may present with spinocerebellar ataxia, polyneuropathy, muscle weakness, and retinopathy. Diagnosis is confirmed through low serum vitamin E levels, and treatment involves dietary supplementation with vitamin E and (if possible) addressing the underlying cause of malabsorption. The term 'vitamin E' commonly refers to α-tocopherol, and so α-tocopherol deficiency refers to the same syndrome.

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Retinopathy in the context of Antimalarial medication

Antimalarial medications or simply antimalarials are a type of antiparasitic chemical agent, often naturally derived, that can be used to treat or to prevent malaria, in the latter case, most often aiming at two susceptible target groups, young children and pregnant women. As of 2018, modern treatments, including for severe malaria, continued to depend on therapies deriving historically from quinine and artesunate, both parenteral (injectable) drugs, expanding from there into the many classes of available modern drugs. Incidence and distribution of the disease ("malaria burden") is expected to remain high, globally, for many years to come; moreover, known antimalarial drugs have repeatedly been observed to elicit resistance in the malaria parasite—including for combination therapies featuring artemisinin, a drug of last resort, where resistance has now been observed in Southeast Asia. As such, the needs for new antimalarial agents and new strategies of treatment (e.g., new combination therapies) remain important priorities in tropical medicine. As well, despite very positive outcomes from many modern treatments, serious side effects can affect some individuals taking standard doses (e.g., retinopathy with chloroquine, acute haemolytic anaemia with tafenoquine).

Specifically, antimalarial drugs may be used to treat malaria in three categories of individuals, (i) those with suspected or confirmed infection, (ii) those visiting a malaria-endemic regions who have no immunity, to prevent infection via malaria prophylaxis, and (iii) or in broader groups of individuals, in routine but intermittent preventative treatment in regions where malaria is endemic via intermittent preventive therapy. Practice in treating cases of malaria is most often based on the concept of combination therapy (e.g., using agents such as artemether and lumefantrine against chloroquine-resistant Plasmodium falciparum infection), since this offers advantages including reduced risk of treatment failure, reduced risk of developed resistance, as well as the possibility of reduced side-effects. Prompt parasitological confirmation by microscopy, or alternatively by rapid diagnostic tests, is recommended in all patients suspected of malaria before treatment is started. Treatment solely on the basis of clinical suspicion is considered when a parasitological diagnosis is not possible.

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Retinopathy in the context of Ocular surface microbiome

The ocular surface microbiome or ocular microbiome refers to the microbiota, including bacteria and fungi, that live on the eye, mainly the conjunctiva and cornea. Flora found on the eyelid and eyelashes are considered to be part of the skin microbiome, although some bacteria are shared across regions. Compared to other human microbiomes, the ocular surface microbiome is sparsely populated and with a low diversity, with approximately one bacterium per 20 recovered epithelial cells. This may be due to the antimicrobial properties of enzymes found in tears, which break down cell walls and prevent bacteria from reproducing.

Some microbes found on the ocular surface have been associated with keratitis, Stevens-Johnson syndrome, trachoma, contact lens-induced dysbiosis, Sjorgen's syndrome, dry eye disease, blepharitis, diabetes-induced dysbiosis and retinopathy. Extended use of contact lenses leads to an increased risk of ocular infections.

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