{"id":10979,"date":"2022-06-14T05:00:37","date_gmt":"2022-06-14T05:00:37","guid":{"rendered":"https:\/\/www.vision-clinic.es\/retinopatia-diabetica-quan-la-diabetis-causa-problemes-oculars\/"},"modified":"2023-08-29T06:36:16","modified_gmt":"2023-08-29T06:36:16","slug":"retinopatia-diabetica-quan-la-diabetis-causa-problemes-oculars","status":"publish","type":"post","link":"https:\/\/www.vision-clinic.es\/ca\/retinopatia-diabetica-quan-la-diabetis-causa-problemes-oculars\/","title":{"rendered":"Retinopatia diab\u00e8tica: quan la diabetis causa problemes oculars"},"content":{"rendered":"\t\t
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La retinopatia diab\u00e8tica \u00e9s una complicaci\u00f3 ocular causada per la diabetis. <\/strong>\u00c9s la malaltia que es produeix quan la diabetis afecta el fons de l’ull, \u00e9s a dir, la retina<\/a>. Els vasos sanguinis de la retina es deterioren i produeixen hemorr\u00e0gies o acumulaci\u00f3 de l\u00edquids que poden provocar p\u00e8rdua d’agudesa visual i fins i tot ceguesa. La Dra Anna Sala<\/a>, especialista de retina de visionclinic+, ens explica quins tractaments hi ha, i ens parla de la import\u00e0ncia de les revisions oculars peri\u00f2diques per prevenir-la.<\/strong><\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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<\/div>\t\t\t\t
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El control de la diabetis, la millor prevenci\u00f3<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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\u00c9s important saber que el bon control de la diabetis des de l’inici de la malaltia \u00e9s la millor estrat\u00e8gia preventiva per endarrerir l’aparici\u00f3 i\/o l’agressivitat de les lesions a la retina. Per\u00f2 com m\u00e9s anys dura la diabetis, m\u00e9s risc hi ha de desenvolupar-la.<\/span><\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Entre els principals factors de risc<\/b> de la retinopatia diab\u00e8tica, hi ha els modificables<\/b>, \u00e9s a dir, que podem modificar o controlar mitjan\u00e7ant un bon estil de vida i controls peri\u00f2dics. Aquests s\u00f3n:\u00a0control de gluc\u00e8mia, pressi\u00f3 arterial, alts nivells de l\u00edpids i els nostres h\u00e0bits de vida. I despr\u00e9s hi ha els <\/span>no modificables<\/b><\/span>, com la<\/span>\u00a0<\/b>duraci\u00f3 de la\u00a0<\/span>diabetis<\/a>, l’edat, la predisposici\u00f3 gen\u00e8tica i l’etnicitat.<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Pot donar s\u00edmptomes o no, per la qual cosa la prevenci\u00f3 passa per fer-se revisions peri\u00f2diques del fons d’ull<\/a><\/strong>.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Dra. Anna Sala<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t

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\"En general, si la retinopatia diab\u00e8tica es detecta a temps i amb els tractaments actuals, en la majoria dels casos s'aconsegueix evitar la p\u00e8rdua visual i, fins i tot, en alguns pacients, millorar-ne la visi\u00f3\"<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Com es diagnostica la retinopatia diab\u00e8tica?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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El diagn\u00f2stic de la retinopatia diab\u00e8tica es fa en detectar les alteracions retinianes caracter\u00edstiques en un examen de fons d’ull<\/strong>. Primer, s’apliquen unes gotes per dilatar les pupil\u00b7les, i despr\u00e9s, es fa aquest examen, simple i indolor. En alguns casos cal visualitzar els vasos sanguinis mitjan\u00e7ant la prova anomenada angiografia fluoresce\u00ednica.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Una altra de les proves imprescindibles en pacients diab\u00e8tics \u00e9s l’OCT (tomografia de coher\u00e8ncia \u00f2ptica)<\/strong><\/a>, una t\u00e8cnica de diagn\u00f2stic, control i seguiment que ha suposat un dels aven\u00e7os m\u00e9s importants de l’oftalmologia en els \u00faltims 20 anys, ja que \u00e9s c\u00f2moda, no invasiva i senzilla de fer. Amb l’OCT veiem la part central anat\u00f2mica de la retina, la m\u00e0cula i totes les capes. <\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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En estat normal, la m\u00e0cula t\u00e9 una depressi\u00f3 central. Si no hi ha aquesta depressi\u00f3, el pacient perd la visi\u00f3 en detall, la visi\u00f3 fina. En pacient diab\u00e8tic, quan hi ha afectaci\u00f3 a la m\u00e0cula en forma d’ac\u00famul de l\u00edquid (Edema Macular Diab\u00e8tic) \u00e9s quan trobem una desestructuraci\u00f3, un augment del gruix i que ha perdut la depressi\u00f3 central, cosa que repercuteix en la visi\u00f3 de forma important.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Dra. Anna Sala<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t

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\"A banda de l'examen de fons d'ull, una altra de les proves claus en pacients diab\u00e8tics \u00e9s l'OCT (tomografia de coher\u00e8ncia \u00f2ptica), que ens permet detectar si hi ha afectaci\u00f3 a la m\u00e0cula en forma d'acumulaci\u00f3 de l\u00edquid (Edema Macular Diab\u00e8tic)\"<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Quins tipus de retinopatia diab\u00e8tica hi ha?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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La retinopatia diab\u00e8tica es classifica en funci\u00f3 dels canvis que presenta el fons de l’ull, i segons la gravetat i extensi\u00f3 de les lesions:<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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\u2022 No proliferativa lleu. <\/span>Canvis lleus al fons d’ull.
\u2022 No proliferativa moderada.<\/span> Canvis greus, per\u00f2 no a tot el fons d’ull.
\u2022 No proliferativa greu.<\/span> Canvis greus i en tot el fons d’ull.
\u2022 Proliferativa. <\/span>La fase m\u00e9s avan\u00e7ada i greu de la malaltia, amb aparici\u00f3 de vasos nous an\u00f2mals i\/o hemorr\u00e0gies internes.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Tamb\u00e9 es classifica en funci\u00f3 de si presenta o no acumulaci\u00f3 de l\u00edquid a la part central de la retina, \u00e9s a dir, si presenta edema macular diab\u00e8tic (EMD) o no.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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L’EMD es presenta nom\u00e9s en el 3% dels ulls amb retinopatia no proliferativa lleu, augmentant al 38% en aquells ulls amb retinopatia no proliferativa de moderada a greu i al 75% en qu\u00e8 tenen retinopatia proliferativa.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Els pacients que pateixen EMD perden visi\u00f3 des del comen\u00e7ament i poden no recuperar-la si no reben el tractament correcte.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Dra. Anna Sala<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t

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\"Els pacients amb retinopatia que no presenten EMD no noten disminuci\u00f3 de l'agudesa visual fins a les formes m\u00e9s greus (proliferativa). Per aix\u00f2 es realitzen controls de fons d'ull, per detectar la pres\u00e8ncia i gravetat de la malaltia com m\u00e9s aviat millor\"
<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t
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Com es pot tractar la retinopatia diab\u00e8tica proliferativa?<\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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El tractament est\u00e0ndard per a la retinopatia diab\u00e8tica proliferativa<\/strong> \u00e9s el tractament amb l\u00e0ser (panfotocoagulaci\u00f3). Tot i aix\u00f2, amb l’arribada de les noves ter\u00e0pies farmacol\u00f2giques han augmentat les opcions terap\u00e8utiques, sent els est\u00e0ndards d’efic\u00e0cia molt m\u00e9s alts que quan el l\u00e0ser era l’\u00fanica opci\u00f3.<\/span><\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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Per aix\u00f2, avui dia, el tractament amb l\u00e0ser per a l'EMD ha quedat limitat a molt pocs casos, i en la majoria la farmacoter\u00e0pia intrav\u00edtria \u00e9s el tractament de primera elecci\u00f3.<\/h4>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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Els f\u00e0rmacs<\/b> aprovats i que s’administren a nivell ocular mitjan\u00e7ant injecci\u00f3<\/b>, per al tractament de l’EMD s\u00f3n:<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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– F\u00e0rmacs anti<\/strong>-VEGF: <\/b> <\/p>\n

Bloquegen l’acci\u00f3 d’una mol\u00e8cula molt implicada a l’edema macular diab\u00e8tic. S\u00f3n f\u00e0rmacs l\u00edquids i s’han d’injectar diverses vegades al llarg de l’any, ja que el seu efecte no sol durar m\u00e9s d’un parell de mesos.<\/p>\n<\/p>\n

– Corticoesteroides: <\/strong> <\/p>\n

Bloquegen la inflamaci\u00f3 ocular que acompanya l’edema macular diab\u00e8tic. S\u00f3n f\u00e0rmacs s\u00f2lids (implants) i poden durar diversos mesos dins de l’ull, per tant, no calen tantes injeccions.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t

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En les fases m\u00e9s avan\u00e7ades i enregistraments de la malaltia, pot ser necessari el tractament quir\u00fargic (vitrectomia pars plana), si hi ha hemorr\u00e0gia v\u00edtria<\/strong> molt densa o recurrent, un despreniment de retina<\/strong> traccional o un edema macular<\/strong> que no respon als tractaments.<\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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\u00c9s una malaltia amb bon pron\u00f2stic? <\/h2>\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
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El pron\u00f2stic visual dep\u00e8n molt del grau d’afectaci\u00f3 de la retinopatia diab\u00e8tica i, sobretot, de si hi ha edema macular diab\u00e8tic o no. Amb els tractaments actuals, si es diagnostica la malaltia a temps, es pot estabilitzar i, en molts casos, no afectar-ne la visi\u00f3. <\/span>Tot i aix\u00f2, algunes persones amb edema macular cr\u00f2nic resistent al tractament poden no recuperar la visi\u00f3 central.<\/span><\/p>\n\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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La retinopatia diab\u00e8tica es produeix quan la diabetis afecta el fons de l’ull, \u00e9s a dir, la retina. El bon control de la diabetis \u00e9s la millor estrat\u00e8gia per prevenir la principal complicaci\u00f3: l’edema macular diab\u00e8tic. Ens ho explica la Dra Anna Sala, que ens parla dels moderns tractaments farmacol\u00f2gics que hi ha.<\/p>\n","protected":false},"author":3,"featured_media":10549,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[141],"tags":[155,153,154],"autores":[129],"tipo_de_blog":[46],"class_list":["post-10979","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-retina-ca","tag-diabetis","tag-retina-ca","tag-retinopatia-diabetica-ca","autores-dra-anna-sala","tipo_de_blog-visionblog","entry"],"acf":[],"yoast_head":"\nRetinopatia diab\u00e8tica: quan la diabetis causa problemes oculars - visi\u00f5ncl\u00ednic<\/title>\n<meta name=\"description\" content=\"La retinopatia diab\u00e8tica es produeix quan la diabetis afecta la retina. 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