Difference between diabetic retinopathy and hypertensive retinopathy

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Retinopathy damages the retina - the part inside the eye that senses light, leading to partial or complete vision loss. Many different conditions can cause retinopathy, which includes high blood pressure and diabetes.

1. Hypertensive retinopathy

1.1. Define

The retina contains many blood vessels. Abnormalities in these vessels are the main cause of retinopathy. Retinopathy can develop slowly or suddenly, resolve on its own or lead to permanent damage. There are several types of retinopathy, including:
Retinopathy of prematurity Diabetic retinopathy Hypertensive retinopathy Central serous retinopathy In which, hypertensive retinopathy is a complication of high blood pressure, leading to damage to the retina and retinal circulatory system. High blood pressure causes blood vessel abnormalities, such as thickening of small arteries, blockage of retinal blood vessels, and bleeding. Sudden, severe high blood pressure can cause swelling of the optic nerve.

1.2. Symptom

Usually hypertensive retinopathy has no symptoms in its early stages, but can cause vision loss or headaches and is detected during routine eye exams.

1.3. Classify

The disease severity scale is based on the Keith-Wagener-Barker classification system as follows:
Grade 1: Torsion of the retinal artery with increased reflectance Grade 2: Grade 1 + Arteriovenous crossover sign ( thickened retinal artery passing through retinal vein) Grade 3: Grade 2 + Flare-shaped haemorrhage and cottony discharge (due to small infarction) Grade 4: Grade 3 + Papilledema (disc edge blurring) ).

1.4. Diagnosis and treatment

Your doctor examines your eyes with an ophthalmoscope to look for pale or white areas of the retina. These areas are pale because there is not enough blood supply. Your doctor can also detect bleeding from a broken blood vessel, as well as swelling of the retina or optic nerve.
The principle of treatment is to prevent, limit and reverse target organ damage (vision) by lowering the patient's blood pressure level (antihypertensive therapy), reducing the risk of vascular disease brain and death. Regular lowering of blood pressure can prevent ongoing damage to the retina. However, some high-risk lesions persist. Therefore, people with very high blood pressure and swelling of the optic nerve need urgent medical attention.

1.5. Prevent

Avoid high blood pressure by:
Exercise regularly Maintain a healthy body weight Eat healthy Eat healthy Check your health regularly Take blood pressure medication as directed.

1.6. Prognosis

Most retinal changes caused by hypertensive retinopathy go away once blood pressure is lowered. Some signs of damage may remain.

2. Diabetic retinopathy

2.1. Define

Diabetic retinopathy develops in people who have had type 1 or type 2 diabetes for many years. There are two types of diabetic retinopathy that can potentially impair vision:
Nonproliferative retinopathy: The blood vessels in the retina are degenerated, blocked, or deformed. Fluid, fat, and protein leak out of the blood vessels, then build up in the retina. This swelling impairs vision. Proliferative retinopathy: New and structurally unstable blood vessels develop on the surface of the retina. These blood vessels frequently cause mild bleeding, local irritation, and scarring. Proliferative retinopathy can cause retinal detachment. This is one of the most serious consequences.

2.2. Symptom

Symptoms of diabetic retinopathy that may go unnoticed until the end stages include:
Blurry vision Sudden loss of vision in one or both eyes Black spots Flashing light Difficulty reading or seeing details.

2.3. Classify

Macular edema can occur at any stage, but is more common in the proliferative stage, where blood vessels leak fluid into the macula.

2.4. Diagnosis and treatment

An ophthalmologist examines the retina and inside of the eye using a lighted instrument called an ophthalmoscope. Dye may be used to expose leaky blood vessels.
Controlling blood sugar and blood pressure can slow or stop the progression of the disease. There are also treatments to repair physical damage. In general, no treatment is needed for mild to moderate nonproliferative disease. Specific treatments depend on the nature and extent of the disease, patient preference, and cost. Treatment options include:
Dispersive laser treatment: To shrink abnormal blood vessels, reduce O2 supply to the retina, and increase O2 delivery to the macula. VEGF growth inhibitor injections: Reduce formation of new blood vessels Vitreous surgery: Removal of bleeding in the vitreous and replacement with sterile normal physiological saline Confocal laser treatment for Macular edema: Reducing fluid leakage and reducing the amount of fluid in the retina Laser treatment does not cure retinopathy but does reduce the severity of visual disturbances. There is also surgery to reattach the retina for retinal detachment or injection of corticosteroids into the eye.
For all types of diabetic retinopathy, it is still necessary to control blood sugar, adjust your diet and exercise regularly so that eye disease does not get worse.

2.5. Prevent

Controlling blood sugar and blood pressure is essential to preventing diabetic retinopathy. Annual eye exams are also important for people with diabetes. If you have diabetic retinopathy, you should have more frequent eye exams. Starting treatment right before vision is affected will help prevent vision loss.

2.6. Prognosis

Prognosis often depends on:
How well blood pressure and blood sugar are controlled The disease has progressed How closely the disease is monitored How treatments can repair damage and slow progression disease progression or not. It should be noted that advanced stages of diabetic retinopathy can lead to blindness.
It can be seen that, whether it is diabetic retinopathy or hypertensive retinopathy, it has negative effects on patients when it makes daily activities difficult and hinders work. . Therefore, it is extremely important to proactively check your health for timely intervention.
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Reference source: health.harvard.edu - slideshare.net - ada.com