Diabetes is not diabetes caused by eating too much sugar. It occurs when the pancreas is no longer able to make insulin, or when the body cannot make good use of the insulin it produces. Sustained high blood sugar can cause serious diseases affecting the heart and blood vessels, eyes, kidneys, nerves and teeth. In addition, people with diabetes are at higher risk of developing infections. Diabetes is the leading cause of cardiovascular disease, blindness, kidney failure and lower limb amputations in almost all high-income countries.

Shockingly, 1 in 10 adults has diabetes. Almost half go undiagnosed.

Diabetic retinopathy is the leading cause of vision loss in adults aged 20-65 years. About one-third of people with diabetes have diabetic retinopathy, and one in 10 will develop the vision-threatening disease. About 70% of diabetic patients have systemic small blood vessel and microvascular disease

Diabetic retinopathy (DR) is one of the most serious complications of diabetic microangiopathy, and has become the leading cause of blindness among adult blind people in developed countries.

In my country, with the increase of diabetic patients, DR has increasingly become an important eye disease that endangers the eyesight of middle-aged patients. Therefore, it is very necessary for the elderly, especially those with diabetes, to check their fundus regularly.

According to the latest epidemiological data in 2020, the proportion of diabetic retinopathy (DR) among patients with type 2 diabetes in my country is as high as 30.1%, and women are especially at greater risk.

Diabetic retinopathy (DR) is the direct result of chronic high blood sugar that damages retinal capillaries, leading to leaky and clogged capillaries that can lead to vision loss and even blindness. Diabetes can also contribute to the development of eye diseases such as cataracts, glaucoma, refractive errors and double vision.
Diabetic retinopathy can lead to blindness, but for most patients, blindness is largely preventable. Diabetic retinopathy is usually asymptomatic in its early stages and requires regular eye examinations to judge the condition of the retina and give appropriate treatment in a timely manner.
Diabetic retinopathy is diagnosed and promptly referred to an ophthalmologist for treatment, laser photocoagulation and/or intravitreal injections can stop further vision loss and in some cases even improve vision if treated early .
When DR progresses to advanced disease (vision has been impaired), the treatment options are very limited, and advanced DR requires repeated treatments (such as laser photocoagulation or intravitreal injection of anti-vascular endothelial growth factor drugs), but the effect is often ineffective. Ideal, resulting in a heavy socio-economic burden. Therefore, it is of great significance to find out the risk factors that can help prevent the occurrence of DR and delay the progression of DR.

In clinical practice, choroidal rupture caused by indirect external force is common. Blunt trauma can cause rapid deformation of the eyeball, leading to anterior and posterior compression and horizontal expansion of the eyeball. Collagen rich sclera and flexible retinal tissue rarely rupture, while bullet free RPE, Bruce membrane and choroidal capillaries are easy to rupture.

The incidence of choroidal rupture accounts for 5%~10% of cases of blunt eye injury, 80% of which occurs in the temporal side of the optic disc or involves the fovea. Histopathology shows choroidal rupture accompanied by hemorrhage, fibrovascular tissue proliferation and RPE proliferation. The retina may have simple loss of outer tissue or continuous interruption of the whole layer of tissue, and the final rupture area will be healed by the reaction of fibroglia.

Traumatic macular hole occurs in about 1.4% of patients after blunt eye injury, which may be the result of combined effects of trauma, cystic degeneration, vascular factors, vitreous traction and other factors, usually formed a few days after injury. Some cases can heal after 6 months, most of them are young people. There is no liquid accumulation at the hole edge, glial cells or RPE cells proliferate at the hole edge, and fill the gap.

But many scholars believe that waiting for self-healing is not a good policy.

Nowadays, OCT inspection is more convenient and fast. The changes of the rupture site before and after surgical treatment can be viewed more . In fact, not only choroidal rupture or macular hole, but also fundus diseases caused by some systemic diseases can be and analyzed through OCT examination, which not only brings clearer examination reports to patients, but also provides more accurate basis for doctors’ clinical diagnosis. It can be said that it plays a “connecting role” examination and treatment.