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Ein Großteil der Patienten– ganze 95 Prozent – ist von Typ-2-Diabetes betroffen. Zudem geht die Forschung von einer großen Dunkelziffer aus: Rund zwei Millionen Menschen wissen bisher noch nichts von ihrer Erkrankung. Pro Tag erhalten etwa 1.600 Menschen erstmals eine Diabetes-Diagnose. ",[],[],{"_uid":2644,"color":46,"plugin":66},"5786b3df-6183-439b-a596-b85fc97be11a",{"_uid":2646,"color":46,"plugin":66},"fd270a12-ba7c-469e-8481-77a94debc9e2",{"id":46,"_uid":2648,"body":2649,"images":2657,"headline":46,"text_ref":2658,"component":2639,"sub_title":46,"margin_top":470,"cta_content":2707,"color_border":2708,"headline_tag":46,"in_container":4,"headline_look":2563,"text_placement":46,"headline_weight":187,"color_background":2710,"padding_vertical":46,"margin_top_mobile":311,"margin_top_desktop":311},"d9de4781-57b0-45d6-abe8-db466a055b88",{"type":74,"content":2650},[2651],{"type":77,"content":2652},[2653],{"text":2654,"type":81,"marks":2655},"Das Auftreten einer Optikusneuritis in Europa liegt bei 5 pro 100.000 Einwohner pro Jahr. Typischerweise sind junge Erwachsene im Alter von 20 bis 40 Jahren betroffen. ",[2656],{"type":326},[],[2659],{"id":46,"_uid":2660,"body":2661,"component":220,"no_margin":3,"margin_top":221},"692dea7b-f174-4ae7-8eb4-e651359178a4",{"type":74,"content":2662},[2663,2673],{"type":318,"attrs":2664,"content":2666},{"level":2665},2,[2667],{"text":2668,"type":81,"marks":2669},"Retinopatia diabetica: una panoramica",[2670],{"type":138,"attrs":2671},{"color":2672},"#000000",{"type":2674,"content":2675},"bullet_list",[2676,2683,2689,2695,2701],{"type":2677,"content":2678},"list_item",[2679],{"type":77,"content":2680},[2681],{"text":2682,"type":81},"La retinopatia diabetica è una patologia della retina, ",{"type":2677,"content":2684},[2685],{"type":77,"content":2686},[2687],{"text":2688,"type":81},"scatenata dalla malattia metabolica del diabete mellito, che comporta il danneggiamento dei vasi sanguigni della retina. ",{"type":2677,"content":2690},[2691],{"type":77,"content":2692},[2693],{"text":2694,"type":81},"I sintomi sono inizialmente poco evidenti, tanto che le persone colpite spesso non se ne rendono conto. ",{"type":2677,"content":2696},[2697],{"type":77,"content":2698},[2699],{"text":2700,"type":81},"Quando il danno visivo è evidente, la retinopatia diabetica è già in fase avanzata. ",{"type":2677,"content":2702},[2703],{"type":77,"content":2704},[2705],{"text":2706,"type":81},"Tuttavia, esistono alcuni trattamenti per prevenire la progressione della malattia e alleviare i danni che ne conseguono. ",[],{"_uid":2709,"color":46,"plugin":66},"0b481311-edbf-436e-ae95-193b84400432",{"_uid":2711,"color":2712,"plugin":66},"b8a18e5f-f032-475f-be3d-db1c1fcadd72","#fce5cd",{"id":46,"_uid":2714,"body":2715,"images":2718,"headline":46,"text_ref":2719,"component":2639,"sub_title":46,"margin_top":470,"cta_content":2720,"subline_ref":2721,"color_border":46,"headline_ref":2722,"headline_tag":46,"in_container":3,"creative_name":46,"headline_look":2563,"promotion_name":46,"text_placement":2723,"headline_weight":187,"color_background":46,"margin_top_mobile":311,"margin_top_desktop":311},"558e3c1f-c3ce-4b97-883f-a4136b266bfd",{"type":74,"content":2716},[2717],{"type":77},[],[],[],[],[],"text-left",{"id":46,"_uid":2725,"body":2726,"images":2792,"headline":2793,"text_ref":2794,"component":2639,"sub_title":46,"margin_top":470,"cta_content":2898,"color_border":2899,"headline_ref":2903,"headline_tag":181,"in_container":3,"headline_look":181,"text_placement":46,"headline_weight":187,"color_background":2908,"margin_top_mobile":311,"margin_top_desktop":311},"24498776-6107-4645-bae8-2a2e3d431dc9",{"type":74,"content":2727},[2728,2736,2744,2752,2760,2768,2776,2784],{"type":77,"content":2729},[2730],{"text":2731,"type":81,"marks":2732},"Was 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Sehnerventzündung",[2757],{"type":86,"attrs":2758},{"href":2759,"uuid":25,"anchor":25,"target":90,"linktype":147},"https:\u002F\u002Fwww.fielmann.de\u002Fratgeber\u002Faugengesundheit\u002Fsehnerventzuendung\u002F#idiopathische",{"type":77,"content":2761},[2762],{"text":2763,"type":81,"marks":2764},"Sehnerventzündung behandeln",[2765],{"type":86,"attrs":2766},{"href":2767,"uuid":25,"anchor":25,"target":90,"linktype":147},"https:\u002F\u002Fwww.fielmann.de\u002Fratgeber\u002Faugengesundheit\u002Fsehnerventzuendung\u002F#behandeln",{"type":77,"content":2769},[2770],{"text":2771,"type":81,"marks":2772},"Was tun bei einer Sehnerventzündung?",[2773],{"type":86,"attrs":2774},{"href":2775,"uuid":25,"anchor":25,"target":90,"linktype":147},"https:\u002F\u002Fwww.fielmann.de\u002Fratgeber\u002Faugengesundheit\u002Fsehnerventzuendung\u002F#was-tun",{"type":77,"content":2777},[2778],{"text":2779,"type":81,"marks":2780},"Fazit: Eine Sehnerventzündung erfordert eine individuelle Behandlung",[2781],{"type":86,"attrs":2782},{"href":2783,"uuid":25,"anchor":25,"target":90,"linktype":147},"https:\u002F\u002Fwww.fielmann.de\u002Fratgeber\u002Faugengesundheit\u002Fsehnerventzuendung\u002F#fazit",{"type":77,"content":2785},[2786],{"text":2787,"type":81,"marks":2788},"Häufige Fragen zur Sehnervenentzündung",[2789],{"type":86,"attrs":2790},{"href":2791,"uuid":25,"anchor":25,"target":90,"linktype":147},"https:\u002F\u002Fwww.fielmann.de\u002Fratgeber\u002Faugengesundheit\u002Fsehnerventzuendung\u002F#faq",[],"Inhalte",[2795],{"id":46,"_uid":2796,"body":2797,"component":220,"no_margin":3,"margin_top":221},"e9bebc81-188d-4c6c-aa78-76d4372deab0",{"type":74,"content":2798},[2799,2809,2819,2829,2839,2849,2878,2888],{"type":77,"content":2800},[2801],{"text":2668,"type":81,"marks":2802},[2803,2806],{"type":86,"attrs":2804},{"href":2805,"uuid":25,"anchor":25,"target":90,"linktype":147},"https:\u002F\u002Fwww.fielmann.it\u002Fguida\u002Fsalute-degli-occhi\u002Fpatologia-oculare-con-il-diabete\u002F#ueberblick",{"type":138,"attrs":2807},{"color":2808},"rgb(0, 0, 0)",{"type":77,"content":2810},[2811],{"text":2812,"type":81,"marks":2813},"Retinopatia diabetico: una definizione",[2814,2817],{"type":86,"attrs":2815},{"href":2816,"uuid":25,"anchor":25,"target":90,"linktype":147},"https:\u002F\u002Fwww.fielmann.it\u002Fguida\u002Fsalute-degli-occhi\u002Fpatologia-oculare-con-il-diabete\u002F#definition",{"type":138,"attrs":2818},{"color":2808},{"type":77,"content":2820},[2821],{"text":2822,"type":81,"marks":2823},"I sintomi della retinopatia diabetica",[2824,2827],{"type":86,"attrs":2825},{"href":2826,"uuid":25,"anchor":25,"target":90,"linktype":147},"https:\u002F\u002Fwww.fielmann.it\u002Fguida\u002Fsalute-degli-occhi\u002Fpatologia-oculare-con-il-diabete\u002F#symptome",{"type":138,"attrs":2828},{"color":2808},{"type":77,"content":2830},[2831],{"text":2832,"type":81,"marks":2833},"Le cause della retinopatia diabetica",[2834,2837],{"type":86,"attrs":2835},{"href":2836,"uuid":25,"anchor":25,"target":90,"linktype":147},"https:\u002F\u002Fwww.fielmann.it\u002Fguida\u002Fsalute-degli-occhi\u002Fpatologia-oculare-con-il-diabete\u002F#ursachen",{"type":138,"attrs":2838},{"color":2808},{"type":77,"content":2840},[2841],{"text":2842,"type":81,"marks":2843},"Gli stadi della retinopatia diabetica",[2844,2847],{"type":86,"attrs":2845},{"href":2846,"uuid":25,"anchor":25,"target":90,"linktype":147},"https:\u002F\u002Fwww.fielmann.it\u002Fguida\u002Fsalute-degli-occhi\u002Fpatologia-oculare-con-il-diabete\u002F#stadien",{"type":138,"attrs":2848},{"color":2808},{"type":77,"content":2850},[2851,2859,2866,2873],{"text":2852,"type":81,"marks":2853},"Il ",[2854,2857],{"type":86,"attrs":2855},{"href":2856,"uuid":25,"anchor":25,"target":90,"linktype":147},"https:\u002F\u002Fwww.fielmann.it\u002Fguida\u002Fsalute-degli-occhi\u002Fpatologia-oculare-con-il-diabete\u002F#behandlung",{"type":138,"attrs":2858},{"color":46},{"text":2860,"type":81,"marks":2861},"trattamento",[2862,2864],{"type":86,"attrs":2863},{"href":2856,"uuid":25,"anchor":25,"target":90,"linktype":147},{"type":138,"attrs":2865},{"color":2617},{"text":2867,"type":81,"marks":2868}," della retinopatia diabetica",[2869,2871],{"type":86,"attrs":2870},{"href":2856,"uuid":25,"anchor":25,"target":90,"linktype":147},{"type":138,"attrs":2872},{"color":46},{"text":2874,"type":81,"marks":2875}," ",[2876],{"type":138,"attrs":2877},{"color":2808},{"type":77,"content":2879},[2880],{"text":2881,"type":81,"marks":2882},"La prevenzione è importante!",[2883,2886],{"type":86,"attrs":2884},{"href":2885,"uuid":25,"anchor":25,"target":90,"linktype":147},"https:\u002F\u002Fwww.fielmann.it\u002Fguida\u002Fsalute-degli-occhi\u002Fpatologia-oculare-con-il-diabete\u002F#vorbeugung",{"type":138,"attrs":2887},{"color":2808},{"type":77,"content":2889},[2890],{"text":2891,"type":81,"marks":2892},"Domande frequenti sulla retinopatia diabetica",[2893,2896],{"type":86,"attrs":2894},{"href":2895,"uuid":25,"anchor":25,"target":90,"linktype":147},"https:\u002F\u002Fwww.fielmann.it\u002Fguida\u002Fsalute-degli-occhi\u002Fpatologia-oculare-con-il-diabete\u002F#faq",{"type":138,"attrs":2897},{"color":2808},[],{"_uid":2900,"color":2901,"plugin":2902},"bcff8913-448b-4bfa-bcdf-9c2354a0ab93","#ffffff","native-color-picker",[2904],{"tag":181,"_uid":2905,"look":181,"text":2906,"color":2907,"weight":187,"component":188},"68ae9bfe-1d1e-4337-a196-9ad93b4f7770","Indice dei contenuti",{"color":46,"plugin":186},{"_uid":2909,"color":2901,"plugin":2902},"792c05a5-ccd7-4e71-ad0d-fb9239d99b96",{"id":2911,"_uid":2912,"body":2913,"images":2924,"headline":46,"text_ref":2925,"component":2639,"sub_title":46,"margin_top":470,"cta_content":2959,"color_border":2960,"headline_tag":46,"in_container":3,"headline_look":2563,"text_placement":46,"headline_weight":187,"color_background":2962,"margin_top_mobile":311,"margin_top_desktop":311},"definition","0ccf3b39-e0a6-4e04-a005-1e31e92199ce",{"type":74,"content":2914},[2915,2920],{"type":318,"attrs":2916,"content":2917},{"level":2665},[2918],{"text":2919,"type":81},"Diabetische Retinopathie – Definition ",{"type":77,"content":2921},[2922],{"text":2923,"type":81},"Bei der diabetischen Retinopathie handelt es sich um eine Erkrankung der Netzhaut, die bei fortgeschrittenem Diabetes auftritt. Zunächst verläuft sie ohne spürbare Symptome, ehe sich in späteren Stadien Schädigungen der Netzhaut zeigen. Feine Blutgefäßwände werden brüchig und es kommt zu Einblutungen und Flüssigkeitsaustritt in die Netzhaut. Im weiteren Verlauf sterben Netzhautzellen ab, was je nach Ort auf der Netzhaut mit sehr unterschiedlichem Einfluss auf die Sehschärfe einhergeht. Später kann es zur Netzhautablösung kommen, die zur Erblindung führen kann. Die diabetische Retinopathie beschränkt sich dabei nicht auf einzelne Bereiche der Netzhaut, sondern betrifft sie im Gesamten. Oft geht sie zusätzlich mit dem diabetischen Makulaödem einher, bei dem sich Flüssigkeit an der Stelle des schärfsten Sehens einlagert, was zu unscharfem und verzerrtem Sehen führt. ",[],[2926],{"id":46,"_uid":2927,"body":2928,"component":220,"no_margin":3,"margin_top":221},"bbb0e2c7-d2e1-4e68-a530-610174289308",{"type":74,"content":2929},[2930,2937],{"type":318,"attrs":2931,"content":2932},{"level":2665},[2933],{"text":2812,"type":81,"marks":2934},[2935],{"type":138,"attrs":2936},{"color":2808},{"type":77,"content":2938},[2939,2944,2949,2954],{"text":2940,"type":81,"marks":2941},"La retinopatia diabetica è una patologia della retina che si può verificare in presenza di diabete in ",[2942],{"type":138,"attrs":2943},{"color":46},{"text":2945,"type":81,"marks":2946},"stadio",[2947],{"type":138,"attrs":2948},{"color":2617},{"text":2950,"type":81,"marks":2951}," avanzato. Inizialmente progredisce senza sintomi evidenti: il danno alla retina appare evidente solo nelle fasi successive. Le sottili pareti dei vasi sanguigni diventano fragili, causando emorragie e perdite di liquido nella retina. Con il progredire della malattia le cellule retiniche muoiono, con effetti molto variabili sull'acuità visiva a seconda della posizione sulla retina. Si può persino arrivare al distacco della retina, che può portare alla cecità. La retinopatia diabetica non è circoscritta a singole aree della retina, ma la colpisce nel suo complesso. Spesso è accompagnata da edema maculare diabetico, in cui del liquido si accumula nel punto in cui la visione è più nitida provocando una visione sfocata e distorta.",[2952],{"type":138,"attrs":2953},{"color":46},{"text":2874,"type":81,"marks":2955},[2956],{"type":138,"attrs":2957},{"color":2958},"rgba(0, 0, 0, 0.847)",[],{"_uid":2961,"color":46,"plugin":66},"1fe2952c-46c2-4c81-a36e-0d1eda323947",{"_uid":2963,"color":46,"plugin":66},"5fc6b5f7-b951-4e77-b39e-aa2f0e286220",{"id":2965,"_uid":2966,"body":2967,"images":3053,"headline":46,"text_ref":3054,"component":2639,"sub_title":46,"margin_top":470,"cta_content":3265,"color_border":3266,"headline_tag":46,"in_container":3,"headline_look":2563,"text_placement":46,"headline_weight":187,"color_background":3268,"margin_top_mobile":311,"margin_top_desktop":311},"symptome","998a1a7a-a39c-41c3-af62-5a47b62e4947",{"type":74,"content":2968},[2969,2974,2978,2983,2987,2995,3000,3004,3011,3016,3020,3024,3029,3033,3040,3045,3049],{"type":318,"attrs":2970,"content":2971},{"level":2665},[2972],{"text":2973,"type":81},"Symptome der diabetischen Retinopathie ",{"type":77,"content":2975},[2976],{"text":2977,"type":81},"Betroffene spüren die diabetische Retinopathie zunächst nicht, da die Veränderungen am Sehvermögen schleichend auftreten. Zudem sind in vielen Fällen im frühen Stadium nur die Randbereiche der Netzhaut betroffen, während das zentrale Gesichtsfeld erst im späteren Verlauf Schaden nimmt.  ",{"type":318,"attrs":2979,"content":2980},{"level":462},[2981],{"text":2982,"type":81},"Verschwommenes Sehen ",{"type":77,"content":2984},[2985],{"text":2986,"type":81},"Betroffenen fällt häufig zuerst auf, dass sie nur noch verschwommen Sehen. Gegenstände, Personen und andere Objekte werden nur noch unscharf erkannt, auch Farben können weniger kräftig erscheinen. Dieser Prozess tritt schleichend auf, sodass viele Betroffene die Erkrankung zunächst nicht bemerken oder für eine altersbedingte Verschlechterung des Sehvermögens halten. ",{"type":77,"content":2988},[2989],{"type":2990,"attrs":2991},"image",{"id":2992,"alt":46,"src":2993,"title":46,"source":46,"copyright":46,"meta_data":2994},15691569,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F141260\u002F1400x534\u002F9a6a2db154\u002Fneu-dda-sehverlust-bei-dmoe-ausgewaschene-verblichene-farbe.jpg",{},{"type":318,"attrs":2996,"content":2997},{"level":462},[2998],{"text":2999,"type":81},"Gesichtsfeldausfälle ",{"type":77,"content":3001},[3002],{"text":3003,"type":81},"Einblutungen in die Netzhaut und Einlagerungen von weiteren ausgetretenen Substanzen können zu Ausfällen im Gesichtsfeld (Skotome) führen, die umso mehr stören, je näher sie in der Gesichtsfeldmitte liegen. Die schlechte Gefäßsituation führt in der Folge zu einem Sauerstoffmangel im Netzhautgewebe, was zum weiteren Untergang von Netzhautzellen führt. ",{"type":77,"content":3005},[3006],{"type":2990,"attrs":3007},{"id":3008,"alt":46,"src":3009,"title":46,"source":46,"copyright":46,"meta_data":3010},15691689,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F141260\u002F1400x534\u002F357906857c\u002Fneu_dda_sehverlust-bei_dmoe_flaechen_mit_skotomen.jpg",{},{"type":318,"attrs":3012,"content":3013},{"level":462},[3014],{"text":3015,"type":81},"Am Ende droht Netzhautablösung ",{"type":77,"content":3017},[3018],{"text":3019,"type":81},"Die desolate Sauerstoffversorgung in der Netzhaut versucht der Körper mit dem Wachstum neuer Gefäße zu beheben. Was zunächst als Problemlösung anmutet, ist in Wirklichkeit eine dramatische Verschärfung der Situation. Die neu wachsenden Gefäße sind von sehr schlechter Qualität und führen zu noch mehr Einblutungen und Flüssigkeitsaustritt. Die austretenden Substanzen verkleben zu einer weißlichen Schicht auf der Netzhaut. Diese zieht sich zusammen und löst dabei die darunterliegende Netzhaut ab. Unbehandelt bedeutet das die Erblindung des Auges. ",{"type":77,"content":3021},[3022],{"text":3023,"type":81},"Wegen dieser schwerwiegenden Konsequenzen muss die diabetische Netzhauterkrankung unbedingt vor der Gefäßwachstumsphase behandelt werden. Reißen Blutgefäße auf und verteilt sich Blut in Form feiner Flecken vor der Netzhaut, können Betroffene dies als kleine, schwarze Punkte im Sichtfeld wahrnehmen, die das Sehen trüben. Dieses Symptom wird auch als „Rußregen-Wahrnehmung“ bezeichnet. Mitunter gehen die Beschwerden zusätzlich mit „Blitz“-Eindrücken einher. Betroffene haben das Gefühl, dass selbst im Dunkeln blitzartig ein helles Licht erscheint – auch bei geschlossenen Augen. Das weist auf Zug an der Netzhaut hin und ist ein wichtiges Alarmzeichen. Das Sehen eines Schattens in einem Gesichtsfeldbereich kann ein Hinweis auf eine beginnende Netzhautablösung sein. ",{"type":318,"attrs":3025,"content":3026},{"level":462},[3027],{"text":3028,"type":81},"Verzerrtes Sehen ",{"type":77,"content":3030},[3031],{"text":3032,"type":81},"Je weiter die Krankheit fortschreitet, desto schwieriger fällt es Betroffenen, klar zu sehen. Zusätzlich kann es früher oder später auch zu Verzerrungen im Blickfeld kommen. Ränder können nicht mehr klar abgegrenzt werden, gerade Linien, wie sie zum Beispiel auf kariertem Papier zu finden sind, werden gekrümmt oder gewellt wahrgenommen. Ursache für das verzerrte Sehen ist meist eine Flüssigkeitseinlagerung, also eine Schwellung in der Mitte der Netzhaut, die durch die diabetische Retinopathie ausgelöst wird. ",{"type":77,"content":3034},[3035],{"type":2990,"attrs":3036},{"id":3037,"alt":46,"src":3038,"title":46,"source":46,"copyright":46,"meta_data":3039},15691660,"https:\u002F\u002Fa.storyblok.com\u002Ff\u002F141260\u002F1400x534\u002Ff9e9946028\u002Fneu_dda-sehverlust-bei-dmoe-metamorphopsien.jpg",{},{"type":318,"attrs":3041,"content":3042},{"level":462},[3043],{"text":3044,"type":81},"Das ganze Auge leidet ",{"type":77,"content":3046},[3047],{"text":3048,"type":81},"Nicht nur die Netzhaut ist vom Diabetes betroffen. Oft kommt es zu einer Eintrübung der Augenlinse (auch als Katarakt bezeichnet) und so zu einer Verschlechterung des Sehvermögens. Diabetiker berichten auch über eine stark schwankende Sehleistung während des Tages. Bei der Messung der passenden Brillenglasstärke kann das zur Herausforderung werden. Auch in Phasen der Therapieumstellung können sich die Brillenglaswerte vorrübergehend verändern. Es ist deshalb sinnvoll, beim Brillenkauf auf einen eventuell vorhandenen Diabetes aufmerksam zu machen. ",{"type":77,"content":3050},[3051],{"text":3052,"type":81},"Wird die diabetische Retinopathie nicht rechtzeitig behandelt, kann es zu einer Netzhautablösung mit anschließender Erblindung kommen. Bei regelmäßiger augenärztlicher Untersuchung stehen zum angebrachten Zeitpunkt verschiedene Therapieoptionen zur Verfügung, die Schlimmeres verhindern.  ",[],[3055],{"id":46,"_uid":3056,"body":3057,"component":220,"no_margin":3,"margin_top":221},"212d3662-7dc7-4342-b960-94266a4b8149",{"type":74,"content":3058},[3059,3066,3077,3085,3106,3111,3119,3178,3182,3190,3206,3214,3221,3225,3233,3240],{"type":318,"attrs":3060,"content":3061},{"level":2665},[3062],{"text":2822,"type":81,"marks":3063},[3064],{"type":138,"attrs":3065},{"color":2808},{"type":77,"content":3067},[3068,3073],{"text":3069,"type":81,"marks":3070},"Inizialmente, dal momento che le alterazioni della vista avvengono gradualmente, le persone colpite non si accorgono della retinopatia diabetica. In molti casi, inoltre, nelle prime fasi sono interessate aree periferiche della retina, mentre il campo visivo centrale viene danneggiato solo in una fase successiva. ",[3071],{"type":138,"attrs":3072},{"color":46},{"text":2874,"type":81,"marks":3074},[3075],{"type":138,"attrs":3076},{"color":2958},{"type":318,"attrs":3078,"content":3079},{"level":462},[3080],{"text":3081,"type":81,"marks":3082},"Visione offuscata",[3083],{"type":138,"attrs":3084},{"color":2808},{"type":77,"content":3086},[3087,3092,3097,3102],{"text":3088,"type":81,"marks":3089},"Spesso il primo segnale avvertito dalle persone affette è una visione offuscata. Oggetti e persone vengono percepiti in modo sfocato e anche i colori possono apparire meno vividi. Questo processo ",[3090],{"type":138,"attrs":3091},{"color":46},{"text":3093,"type":81,"marks":3094},"avviene",[3095],{"type":138,"attrs":3096},{"color":2617},{"text":3098,"type":81,"marks":3099}," gradualmente, tanto che molti non si accorgono subito della malattia o pensano che si tratti di un deterioramento della vista dovuto all'età.",[3100],{"type":138,"attrs":3101},{"color":46},{"text":2874,"type":81,"marks":3103},[3104],{"type":138,"attrs":3105},{"color":2958},{"type":77,"content":3107},[3108],{"type":2990,"attrs":3109},{"id":2992,"alt":46,"src":2993,"title":46,"source":46,"copyright":46,"meta_data":3110},"[object Object]",{"type":318,"attrs":3112,"content":3113},{"level":462},[3114],{"text":3115,"type":81,"marks":3116},"Perdite del campo visivo",[3117],{"type":138,"attrs":3118},{"color":2808},{"type":77,"content":3120},[3121,3126,3131,3136,3169,3174],{"text":3122,"type":81,"marks":3123},"Le emorragie nella retina e i depositi di altre sostanze fuoriuscite possono portare a difetti del campo ",[3124],{"type":138,"attrs":3125},{"color":46},{"text":3127,"type":81,"marks":3128},"visivo",[3129],{"type":138,"attrs":3130},{"color":2617},{"text":3132,"type":81,"marks":3133}," (",[3134],{"type":138,"attrs":3135},{"color":46},{"text":3137,"type":81,"marks":3138},"scotomi",[3139,3167],{"type":86,"attrs":3140},{"href":3141,"uuid":3142,"anchor":25,"target":90,"linktype":91,"story":3143,"original_href":3149},"\u002Fguida\u002Fsalute-degli-occhi\u002Fscotoma\u002F","c9a807f4-bdc8-4bd5-89d7-8c7acbdc0b28",{"id":3144,"uuid":3142,"slug":3145,"full_slug":3141,"path":3146,"parent_id":3147,"name":3148,"is_folder":3,"published":4,"is_startpage":3,"position":582,"real_path":3149,"alternates":3150,"_stopResolving":4},689172862,"skotom","skotom\u002F",689172760,"Skotom","\u002Fratgeber\u002Faugengesundheit\u002Fskotom\u002F",[3151,3153,3154,3155,3156,3157,3158,3161,3162,3163,3164,3165,3166],{"path":3152,"name":25,"lang":102,"published":25},"it-it\u002Fcontent\u002Fratgeber\u002Faugengesundheit\u002Fskotom",{"path":3152,"name":25,"lang":104,"published":25},{"path":3152,"name":25,"lang":106,"published":25},{"path":3152,"name":25,"lang":108,"published":25},{"path":3152,"name":25,"lang":110,"published":25},{"path":3152,"name":25,"lang":112,"published":25},{"path":3159,"name":3160,"lang":115,"published":4},"it-it\u002Fcontent\u002Fguida\u002Fsalute-degli-occhi\u002Fscotoma","scotoma",{"path":3152,"name":25,"lang":117,"published":25},{"path":3152,"name":25,"lang":119,"published":25},{"path":3152,"name":25,"lang":121,"published":25},{"path":3152,"name":25,"lang":123,"published":25},{"path":3152,"name":25,"lang":125,"published":25},{"path":3152,"name":25,"lang":127,"published":25},{"type":138,"attrs":3168},{"color":46},{"text":3170,"type":81,"marks":3171},"), tanto più fastidiosi quanto più sono vicini al centro del campo visivo. La scarsa vascolarizzazione porta poi a una mancanza di ossigeno nel tessuto retinico, con la conseguenza di un'ulteriore distruzione di cellule retiniche.",[3172],{"type":138,"attrs":3173},{"color":46},{"text":2874,"type":81,"marks":3175},[3176],{"type":138,"attrs":3177},{"color":2958},{"type":77,"content":3179},[3180],{"type":2990,"attrs":3181},{"id":3008,"alt":46,"src":3009,"title":46,"source":46,"copyright":46,"meta_data":3110},{"type":318,"attrs":3183,"content":3184},{"level":462},[3185],{"text":3186,"type":81,"marks":3187},"C'è il rischio di distacco della retina ",[3188],{"type":138,"attrs":3189},{"color":46},{"type":77,"content":3191},[3192,3196,3201],{"text":2874,"type":81,"marks":3193},[3194],{"type":138,"attrs":3195},{"color":46},{"text":3197,"type":81,"marks":3198},"L'organismo",[3199],{"type":138,"attrs":3200},{"color":2617},{"text":3202,"type":81,"marks":3203}," cerca di porre rimedio alla carenza di ossigeno nella retina facendo crescere nuovi vasi sanguigni. Quella che inizialmente sembra essere una soluzione al problema, però, è in realtà un drammatico aggravamento. I nuovi vasi sono di qualità molto scadente e provocano ulteriori emorragie e perdite di liquido. Le sostanze fuoriuscite si uniscono e formano sulla retina uno strato biancastro, che si contrae staccando la retina sottostante. Se non trattata, la malattia provoca la cecità dell'occhio. Vista la gravità delle possibili conseguenze, la retinopatia diabetica deve essere trattata prima della fase di vascolarizzazione. Se i vasi sanguigni si rompono e il sangue si diffonde sotto forma di sottili macchie davanti alla retina, queste possono essere percepite come puntini neri nel campo visivo che offuscano la visione, Questo sintomo, a cui ci si riferisce anche come \"pioggia fuligginosa\", è talvolta accompagnato dall'impressione di vedere dei \"fulmini\". Le persone colpite hanno la sensazione di percepire una luce intensa, simile a un lampo, anche al buio e con occhi chiusi. Questo indica una tensione sulla retina ed è un importante segnale di allarme. Vedere un'ombra in un'area del viso può essere un'indicazione di un distacco retinico incipiente. ",[3204],{"type":138,"attrs":3205},{"color":46},{"type":318,"attrs":3207,"content":3208},{"level":462},[3209],{"text":3210,"type":81,"marks":3211},"Visione distorta",[3212],{"type":138,"attrs":3213},{"color":2808},{"type":77,"content":3215},[3216],{"text":3217,"type":81,"marks":3218},"Più la malattia progredisce, più diventa difficile per le persone affette vedere chiaramente. In fase avanzata possono verificarsi anche distorsioni del campo visivo. I bordi non appaiono più chiaramente delineati, le linee rette, come quelle della carta a quadretti, sono percepite come curve o ondulate. La causa della visione distorta è solitamente una ritenzione di liquidi, ossia un rigonfiamento al centro della retina, provocato dalla retinopatia diabetica. ",[3219],{"type":138,"attrs":3220},{"color":46},{"type":77,"content":3222},[3223],{"type":2990,"attrs":3224},{"id":3037,"alt":46,"src":3038,"title":46,"source":46,"copyright":46,"meta_data":3110},{"type":318,"attrs":3226,"content":3227},{"level":462},[3228],{"text":3229,"type":81,"marks":3230},"Soffre l'intero occhio ",[3231],{"type":138,"attrs":3232},{"color":46},{"type":77,"content":3234},[3235],{"text":3236,"type":81,"marks":3237},"Il diabete non colpisce solo la retina: spesso, infatti, porta a un offuscamento del cristallino (noto anche come cataratta) e quindi a un peggioramento della vista. I diabetici riferiscono anche di prestazioni visive fortemente fluttuanti durante il giorno, il che può essere d'ostacolo quando si deve misurare la giusta gradazione delle lenti. I valori della vista possono cambiare temporaneamente anche durante le fasi di cambio di terapia. È quindi opportuno prestare attenzione all'eventuale presenza di diabete al momento dell'acquisto degli occhiali. ",[3238],{"type":138,"attrs":3239},{"color":46},{"type":77,"content":3241},[3242,3247,3252,3257,3261],{"text":3243,"type":81,"marks":3244},"Se la retinopatia diabetica non viene trattata in tempo può portare al distacco della retina e ",[3245],{"type":138,"attrs":3246},{"color":46},{"text":3248,"type":81,"marks":3249},"conseguentemente",[3250],{"type":138,"attrs":3251},{"color":2617},{"text":3253,"type":81,"marks":3254}," alla cecità. Esami oculistici regolari, però, consentono di intervenire al momento opportuno con varie opzioni terapeutiche volte a prevenire il peggioramento della situazione. ",[3255],{"type":138,"attrs":3256},{"color":46},{"text":2874,"type":81,"marks":3258},[3259],{"type":138,"attrs":3260},{"color":2958},{"text":2874,"type":81,"marks":3262},[3263],{"type":138,"attrs":3264},{"color":46},[],{"_uid":3267,"color":46,"plugin":66},"e4d9dfea-3bbf-4ba8-827e-4fd0bdf03d92",{"_uid":3269,"color":46,"plugin":66},"b639f449-1230-4c6c-8863-1694bf7488a5",{"id":3271,"_uid":3272,"body":3273,"images":3328,"headline":3329,"text_ref":3330,"component":2639,"sub_title":46,"margin_top":470,"cta_content":3427,"color_border":3428,"headline_ref":3430,"headline_tag":181,"in_container":3,"headline_look":181,"text_placement":46,"headline_weight":187,"color_background":3434,"margin_top_mobile":311,"margin_top_desktop":311},"Ursachen","1388219c-eb1a-4f4b-83d9-89f72868feb5",{"type":74,"content":3274},[3275,3279,3282,3286],{"type":77,"content":3276},[3277],{"text":3278,"type":81},"Die Netzhautprobleme bei der diabetischen Retinopathie entstehen durch instabile Blutgefäße. Ist der Blutzucker erhöht, kommt es auf Dauer zu Schäden an den Gefäßwänden – und das im gesamten Körper. Gar nicht selten ist gleichzeitig der Blutdruck erhöht, was die Gefäße zusätzlich belastet.  Die besonders kleinen und empfindlichen Kapillargefäße im Auge sind davon besonders betroffen. Durch die andauernde Belastung zeigen sich im Laufe der Zeit erste Schäden – brüchige und verdickte Gefäßwände und Gefäßerweiterungen. Das ist die erste Phase einer diabetischen Retinopathie. ",{"type":77,"content":3280},[3281],{"text":211,"type":81},{"type":77,"content":3283},[3284],{"text":3285,"type":81},"Während Typ-1-Diabetes und Typ-2-Diabetes als Hauptursache für die diabetische Retinopathie gelten, können weitere Faktoren die Krankheit zusätzlich verschlimmern: ",{"type":2674,"content":3287},[3288,3298,3308,3318],{"type":2677,"content":3289},[3290],{"type":77,"content":3291},[3292,3296],{"text":3293,"type":81,"marks":3294},"Erkrankungsdauer",[3295],{"type":326},{"text":3297,"type":81},": Je länger die Erkrankung besteht und je später sie erkannt wird, desto schwieriger gestaltet sich die Behandlung. Regelmäßige augenärztliche Kontrolle ist deshalb entscheidend.  ",{"type":2677,"content":3299},[3300],{"type":77,"content":3301},[3302,3306],{"text":3303,"type":81,"marks":3304},"Bluthochdruck",[3305],{"type":326},{"text":3307,"type":81},": Dabei werden die feinen Blutgefäße der Netzhaut zusätzlich geschädigt und es kommt zu vermehrten Einblutungen und Flüssigkeitsaustritt ins Gewebe.  ",{"type":2677,"content":3309},[3310],{"type":77,"content":3311},[3312,3316],{"text":3313,"type":81,"marks":3314},"Pubertät\u002FSchwangerschaft",[3315],{"type":326},{"text":3317,"type":81},": Aufgrund der hormonellen Veränderungen in Pubertät und Schwangerschaft kann es zu einer Verschlechterung der diabetischen Retinopathie kommen. ",{"type":2677,"content":3319},[3320],{"type":77,"content":3321},[3322,3326],{"text":3323,"type":81,"marks":3324},"Rauchen",[3325],{"type":326},{"text":3327,"type":81},": Rauchen sorgt für eine Verschlechterung der Gefäßgesundheit, was die Entwicklung der diabetischen Retinopathie fördert. ",[],"Ursachen für die diabetische Retinopathie",[3331],{"id":46,"_uid":3332,"body":3333,"component":220,"no_margin":3,"margin_top":221},"6c04ee42-d832-447b-ace3-b6c88360284f",{"type":74,"content":3334},[3335,3352,3359,3376,3393,3410],{"type":77,"content":3336},[3337,3342,3347],{"text":3338,"type":81,"marks":3339},"I problemi retinici associati alla retinopatia diabetica sono causati dall'instabilità dei vasi sanguigni. Una glicemia elevata, nel lungo termine, danneggia le pareti dei vasi sanguigni in tutto il corpo. Non è ",[3340],{"type":138,"attrs":3341},{"color":46},{"text":3343,"type":81,"marks":3344},"raro",[3345],{"type":138,"attrs":3346},{"color":2617},{"text":3348,"type":81,"marks":3349}," che essa sia abbinata a una pressione arteriosa elevata, il che comporta un'ulteriore sollecitazione dei vasi sanguigni. I capillari dell'occhio, particolarmente piccoli e sensibili, sono particolarmente vulnerabili. Con il tempo compaiono i primi segni della sollecitazione: pareti dei vasi fragili e ispessite e vasodilatazione. Questa è la prima fase della retinopatia diabetica. ",[3350],{"type":138,"attrs":3351},{"color":46},{"type":77,"content":3353},[3354],{"text":3355,"type":81,"marks":3356},"Sebbene il diabete di tipo 1 e il diabete di tipo 2 siano considerati le cause principali della retinopatia diabetica, anche altri fattori possono aggravare la malattia: ",[3357],{"type":138,"attrs":3358},{"color":46},{"type":2674,"content":3360},[3361],{"type":2677,"content":3362},[3363],{"type":77,"content":3364},[3365,3371],{"text":3366,"type":81,"marks":3367},"Durata della malattia",[3368,3369],{"type":326},{"type":138,"attrs":3370},{"color":46},{"text":3372,"type":81,"marks":3373},": tanto più lunga è la malattia e tanto più tardi viene diagnosticata, tanto più difficile risulta il trattamento. Per questo è fondamentale sottoporsi a regolari controlli oculistici.  ",[3374],{"type":138,"attrs":3375},{"color":46},{"type":2674,"content":3377},[3378],{"type":2677,"content":3379},[3380],{"type":77,"content":3381},[3382,3388],{"text":3383,"type":81,"marks":3384},"Pressione sanguigna elevata",[3385,3386],{"type":326},{"type":138,"attrs":3387},{"color":46},{"text":3389,"type":81,"marks":3390},": provoca ulteriori danni ai sottili vasi sanguigni della retina portando a un aumento delle emorragie e alla fuoriuscita di liquido nel tessuto.  ",[3391],{"type":138,"attrs":3392},{"color":46},{"type":2674,"content":3394},[3395],{"type":2677,"content":3396},[3397],{"type":77,"content":3398},[3399,3405],{"text":3400,"type":81,"marks":3401},"Pubertà\u002Fgravidanza",[3402,3403],{"type":326},{"type":138,"attrs":3404},{"color":46},{"text":3406,"type":81,"marks":3407},": i cambiamenti ormonali durante la pubertà e la gravidanza possono portare a un peggioramento della retinopatia diabetica. ",[3408],{"type":138,"attrs":3409},{"color":46},{"type":2674,"content":3411},[3412],{"type":2677,"content":3413},[3414],{"type":77,"content":3415},[3416,3422],{"text":3417,"type":81,"marks":3418},"Fumo",[3419,3420],{"type":326},{"type":138,"attrs":3421},{"color":46},{"text":3423,"type":81,"marks":3424},": il fumo provoca un deterioramento della salute vascolare, che favorisce l'insorgenza della retinopatia diabetica. ",[3425],{"type":138,"attrs":3426},{"color":46},[],{"_uid":3429,"color":46,"plugin":66},"8b51003c-5a89-4c53-8971-f81db5ae988f",[3431],{"tag":181,"_uid":3432,"look":181,"text":2832,"color":3433,"weight":187,"component":188},"2089d76c-fe2e-451d-b9d0-4aff94928b95",{"color":46,"plugin":186},{"_uid":3435,"color":46,"plugin":66},"ff3e9de0-4dd3-44ed-8b62-8499dccc1bec",{"id":46,"_uid":3437,"body":3438,"images":3446,"headline":46,"text_ref":3447,"component":2639,"sub_title":46,"margin_top":470,"cta_content":3463,"color_border":3464,"headline_tag":46,"in_container":4,"headline_look":2563,"text_placement":46,"headline_weight":187,"color_background":3466,"padding_vertical":46,"margin_top_mobile":311,"margin_top_desktop":311},"41e6f9c8-b948-441f-b256-d9ce491f7c92",{"type":74,"content":3439},[3440],{"type":77,"content":3441},[3442],{"text":3443,"type":81,"marks":3444},"Jeder vierte Diabetiker* ist von einer diabetischen Retinopathie betroffen – schwere Verläufe sind durch regelmäßige Vorsorgeuntersuchungen jedoch vermeidbar. ",[3445],{"type":326},[],[3448],{"id":46,"_uid":3449,"body":3450,"component":220,"no_margin":3,"margin_top":221},"88369157-2d40-4c66-b801-5624e1f6d16a",{"type":74,"content":3451},[3452],{"type":77,"content":3453},[3454,3459],{"text":3455,"type":81,"marks":3456},"Un diabetico su quattro è affetto da retinopatia diabetica, ma i casi più gravi si possono prevenire con controlli regolari.",[3457],{"type":138,"attrs":3458},{"color":46},{"text":2874,"type":81,"marks":3460},[3461],{"type":138,"attrs":3462},{"color":2958},[],{"_uid":3465,"color":46,"plugin":66},"d97bae0e-d1a7-4c11-a060-8faaa534d31c",{"_uid":3467,"color":3468,"plugin":66},"ef71cfdf-410b-4cc2-968f-262a36e1d3b0","#f3f3f3",{"id":3470,"_uid":3471,"columns":3472,"component":3704,"margin_top":46,"in_container":3},"stadien","f0ad3e37-2948-4387-9665-1ae72ef4964a",[3473,3609],{"id":46,"_uid":3474,"body":3475,"images":3508,"headline":46,"text_ref":3509,"component":2639,"sub_title":46,"margin_top":470,"cta_content":3604,"color_border":3605,"headline_tag":46,"in_container":3,"headline_look":2563,"text_placement":46,"headline_weight":187,"color_background":3607,"margin_top_mobile":311,"margin_top_desktop":311},"7f9e35d8-7c68-4e25-b7ab-9a40a02fb094",{"type":74,"content":3476},[3477,3482,3486,3491,3495,3499,3504],{"type":318,"attrs":3478,"content":3479},{"level":2665},[3480],{"text":3481,"type":81},"Stadien der diabetischen Retinopathie ",{"type":77,"content":3483},[3484],{"text":3485,"type":81},"Der schleichende Verlauf ist es, der die diabetische Retinopathie zu einer so tückischen Krankheit macht. Im Frühstadium ist die Erkrankung noch gut behandelbar, während sich die Behandlung im fortgeschrittenen Stadium deutlich schwieriger gestaltet. Bei besonders schweren Verläufen kann es auch zu einem Funktionsverlust und bleibenden Schäden am Auge kommen. ",{"type":318,"attrs":3487,"content":3488},{"level":462},[3489],{"text":3490,"type":81},"Nicht-proliferative diabetische Retinopathie (NPDR) – das Frühstadium ",{"type":77,"content":3492},[3493],{"text":3494,"type":81},"Im Frühstadium der Erkrankung spricht man von einer nicht-proliferativen diabetischen Retinopathie. Betroffene bemerken meist noch keine Symptome, häufig wird die Erkrankung in diesem Stadium durch einen Arzt festgestellt. Erste Anzeichen sind Gefäßerweiterungen, retinale Blutungen, Aussackungen der Kapillare und Fettablagerungen im Auge. Mitunter kommt es auch zu Flüssigkeitseinlagerungen in die Netzhaut.  ",{"type":77,"content":3496},[3497],{"text":3498,"type":81},"Die nicht-proliferative diabetische Retinopathie lässt sich in leichte und schwere Verläufe einteilen. Beim leichten Verlauf ist zunächst keine weitere Behandlung notwendig, abgesehen davon, dass der Blutzucker korrekt eingestellt und weitere Begleiterkrankungen wie Bluthochdruck behandelt werden sollten. Außerdem sind regelmäßige augenärztliche Kontrolluntersuchungen notwendig, um ein Fortschreiten der Krankheit frühestmöglich zu erkennen. Kommt die Erkrankung in die schwere nicht-proliferative Phase, kann eine Laserbehandlung der Netzhaut ein weiteres Voranschreiten in die proliferative Phase verhindern. ",{"type":318,"attrs":3500,"content":3501},{"level":462},[3502],{"text":3503,"type":81},"Proliferative diabetische Retinopathie – das Spätstadium ",{"type":77,"content":3505},[3506],{"text":3507,"type":81},"Wird die Erkrankung nicht rechtzeitig behandelt, kommt es aufgrund der dauerhaften Unterversorgung der Netzhautzellen zu ernsten Veränderungen. ",[],[3510],{"id":46,"_uid":3511,"body":3512,"component":220,"no_margin":3,"margin_top":221},"2e05db48-7472-4269-a740-d7b0df687fd5",{"type":74,"content":3513},[3514,3521,3538,3555,3572,3578,3585,3593],{"type":318,"attrs":3515,"content":3516},{"level":2665},[3517],{"text":2842,"type":81,"marks":3518},[3519],{"type":138,"attrs":3520},{"color":2808},{"type":77,"content":3522},[3523,3528,3533],{"text":3524,"type":81,"marks":3525},"È la progressione graduale che rende la retinopatia diabetica una malattia così insidiosa. Nelle fasi ",[3526],{"type":138,"attrs":3527},{"color":46},{"text":3529,"type":81,"marks":3530},"iniziali",[3531],{"type":138,"attrs":3532},{"color":2617},{"text":3534,"type":81,"marks":3535}," la malattia è ancora facilmente curabile, mentre in stadio avanzato il trattamento è molto più complesso. In casi particolarmente gravi, può anche portare alla perdita di funzionalità e a danni permanenti all'occhio. ",[3536],{"type":138,"attrs":3537},{"color":46},{"type":318,"attrs":3539,"content":3540},{"level":462},[3541,3546,3551],{"text":3542,"type":81,"marks":3543},"Retinopatia",[3544],{"type":138,"attrs":3545},{"color":2617},{"text":3547,"type":81,"marks":3548}," diabetica non proliferante (NPDR): lo stadio iniziale",[3549],{"type":138,"attrs":3550},{"color":46},{"text":2874,"type":81,"marks":3552},[3553],{"type":138,"attrs":3554},{"color":2808},{"type":77,"content":3556},[3557,3562,3567],{"text":3558,"type":81,"marks":3559},"Nelle ",[3560],{"type":138,"attrs":3561},{"color":46},{"text":3563,"type":81,"marks":3564},"fasi",[3565],{"type":138,"attrs":3566},{"color":2617},{"text":3568,"type":81,"marks":3569}," iniziali della malattia, si parla di retinopatia diabetica non proliferante. Di norma le persone colpite non notano ancora alcun sintomo e se viene diagnosticata, è grazie a un medico. I primi segni sono vasodilatazione, emorragie retiniche, rigonfiamento dei capillari e depositi di grasso nell'occhio. Talvolta si riscontra anche una ritenzione di liquidi nella retina.  ",[3570],{"type":138,"attrs":3571},{"color":46},{"type":77,"content":3573},[3574],{"text":2874,"type":81,"marks":3575},[3576],{"type":138,"attrs":3577},{"color":46},{"type":77,"content":3579},[3580],{"text":3581,"type":81,"marks":3582},"La retinopatia diabetica non proliferante si può suddividere in forme lievi e gravi. Nei casi lievi, inizialmente non è necessario alcun trattamento, a parte la corretta regolazione della glicemia e il trattamento di eventuali patologie concomitanti come l'ipertensione arteriosa. Sono inoltre necessari regolari controlli oculistici per rilevare il più precocemente possibile l'eventuale progressione della patologia. Se la malattia entra nella fase non proliferante grave, il trattamento laser della retina può prevenire l'ulteriore progressione verso la fase proliferante. ",[3583],{"type":138,"attrs":3584},{"color":46},{"type":318,"attrs":3586,"content":3587},{"level":462},[3588],{"text":3589,"type":81,"marks":3590},"Retinopatia diabetica proliferante: lo stadio avanzato",[3591],{"type":138,"attrs":3592},{"color":2808},{"type":77,"content":3594},[3595,3597,3602],{"text":3596,"type":81},"Se la malattia non viene trattata in tempo si verificano gravi alterazioni dovute alla permanente ",{"text":3598,"type":81,"marks":3599},"carenza",[3600],{"type":138,"attrs":3601},{"color":2617},{"text":3603,"type":81}," di ossigeno delle cellule retiniche. ",[],{"_uid":3606,"color":2901,"plugin":2902},"da97d7a3-1817-40d3-b838-a8b51945209b",{"_uid":3608,"color":2901,"plugin":2902},"90f14605-99e4-4eb7-b2cf-ea45ff011273",{"id":46,"_uid":3610,"body":3611,"images":3638,"headline":46,"text_ref":3639,"component":2639,"sub_title":46,"margin_top":470,"cta_content":3699,"color_border":3700,"headline_tag":46,"in_container":3,"headline_look":2563,"text_placement":46,"headline_weight":187,"color_background":3702,"margin_top_mobile":311,"margin_top_desktop":311},"b9cd5420-8425-4b26-a994-f74cc873d1cc",{"type":74,"content":3612},[3613,3617,3621,3625,3629,3634],{"type":77,"content":3614},[3615],{"text":3616,"type":81},"Die Netzhautzellen reagieren auf den anhaltenden Sauerstoffmangel mit der Ausschüttung von Signalstoffen, die zu einer Neubildung von Gefäßen (Proliferation bzw. Neovaskularisation) führen. Diese Gefäße sind von minderwertiger Qualität und undicht, sodass Flüssigkeit in die Netzhaut gelangt und vermehrt Einblutungen entstehen. Dringt das Blut in den Glaskörperraum ein, kann sich dies in Form von plötzlichen und starken Seheinschränkungen äußern.  ",{"type":77,"content":3618},[3619],{"text":3620,"type":81},"Im weiteren Verlauf kommt es in diesem Stadium der diabetischen Retinopathie zur Membran-Bildung auf der Netzhaut. Diese von Narbensträngen durchzogenen Häutchen können sich zusammenziehen und die Netzhaut ablösen. Eine vollständige Erblindung droht. ",{"type":77,"content":3622},[3623],{"text":3624,"type":81},"Je länger die diabetische Retinopathie unbehandelt bleibt, desto eher drohen schwere Folgeschäden. So kann es im Verlauf der Erkrankung auch zur Bildung neuer, schadhafter Gefäße im vorderen Bereich des Auges kommen. Diese Gefäße entstehen auf der Regenbogenhaut (Iris) und wachsen weiter in den Kammerwinkel, also den Bereich, in dem das Kammerwasser abfließt. Es droht ein nur schwer behandelbarer Anstieg des Augeninnendrucks. ",{"type":77,"content":3626},[3627],{"text":3628,"type":81},"Die proliferative diabetische Retinopathie sollte umgehend von einem fachkundigen Augenarzt behandelt werden, damit dauerhafte Schäden verhindert oder zumindest reduziert werden können.  ",{"type":318,"attrs":3630,"content":3631},{"level":462},[3632],{"text":3633,"type":81},"Diabetisches Makulaödem – eine weitere Folge der Erkrankung ",{"type":77,"content":3635},[3636],{"text":3637,"type":81},"Führt die diabetische Retinopathie zu einer Netzhautveränderung in der Makula (also dem Bereich, an dem das Auge am schärfsten sieht), spricht man von einer diabetischen Makulopathie. Dieses Erscheinungsbild der diabetischen Retinopathie kann in unterschiedlichen Phasen der Erkrankung auftreten. Durch einen Flüssigkeitsaustritt aus den kleinen Gefäßen im Auge entsteht hier eine Schwellung in der Mitte der Netzhaut, das sogenannte Makulaödem. Dies führt zu einer Beeinträchtigung des Sehvermögens und kann, wenn es nicht behandelt wird, zu einer dauerhaften Schädigung der zentralen Netzhaut führen, sodass das Auge unwiederbringlich an Funktionskraft verliert. Auch hier kann eine rechtzeitige Therapie für Linderung sorgen, sodass die Sehkraft in der Regel erhalten bleibt. ",[],[3640],{"id":46,"_uid":3641,"body":3642,"component":220,"no_margin":3,"margin_top":221},"f2a79ff9-c61a-4a29-a4a4-aaba678eeb30",{"type":74,"content":3643},[3644,3648,3655,3662,3669,3677,3698],{"type":77,"content":3645},[3646],{"text":3647,"type":81},"Le cellule retiniche reagiscono alla persistente mancanza di ossigeno rilasciando sostanze di segnalazione che portano alla formazione di nuovi vasi sanguigni (proliferazione o neovascolarizzazione). Essendo di qualità inferiore e soggetti a perdite, questi vasi fanno penetrare liquido nella retina causando un aumento delle emorragie. Se il sangue penetra nel corpo vitreo, si può manifestare una grave e improvvisa riduzione della vista.",{"type":77,"content":3649},[3650],{"text":3651,"type":81,"marks":3652},"Con il progredire della retinopatia diabetica, sulla retina si formano delle membrane che, intervallate da filamenti cicatriziali, possono contrarsi e staccare la retina. A quel punto sussiste il rischio di cecità completa. ",[3653],{"type":138,"attrs":3654},{"color":46},{"type":77,"content":3656},[3657],{"text":3658,"type":81,"marks":3659},"Più a lungo la retinopatia diabetica non viene trattata, maggiore è il rischio di conseguenze gravi. Con il progredire della malattia, possono formarsi nuovi vasi deficitari anche nella parte anteriore dell'occhio. Questi vasi nascono sull'iride e crescono nell'umor acqueo, ossia nell'area in cui l'umor acqueo defluisce. In tal caso il rischio è di un aumento della pressione intraoculare difficile da trattare. ",[3660],{"type":138,"attrs":3661},{"color":46},{"type":77,"content":3663},[3664],{"text":3665,"type":81,"marks":3666}," La retinopatia diabetica proliferante deve essere trattata immediatamente da un oculista specializzato, in modo da prevenire o almeno ridurre i danni permanenti.  ",[3667],{"type":138,"attrs":3668},{"color":46},{"type":318,"attrs":3670,"content":3671},{"level":462},[3672],{"text":3673,"type":81,"marks":3674},"Edema maculare diabetico: un'altra conseguenza della malattia",[3675],{"type":138,"attrs":3676},{"color":2808},{"type":77,"content":3678},[3679,3684,3689,3694],{"text":3680,"type":81,"marks":3681},"Se la retinopatia diabetica provoca un'alterazione della retina nella macula (l'area in cui l'occhio vede più ",[3682],{"type":138,"attrs":3683},{"color":46},{"text":3685,"type":81,"marks":3686},"nitidamente",[3687],{"type":138,"attrs":3688},{"color":2617},{"text":3690,"type":81,"marks":3691},"), si parla di maculopatia diabetica. Questo effetto della retinopatia diabetica può verificarsi in diverse fasi della malattia. Una perdita di liquido dai piccoli vasi dell'occhio provoca un rigonfiamento al centro della retina noto come edema maculare. Tale rigonfiamento comporta una riduzione della vista e, se non trattato, può provocare danni permanenti alla retina centrale, fino alla perdita irreversibile della capacità funzionale dell'occhio. Anche in questo caso una terapia tempestiva può dare sollievo e aiutare a preservare la vista.",[3692],{"type":138,"attrs":3693},{"color":46},{"text":2874,"type":81,"marks":3695},[3696],{"type":138,"attrs":3697},{"color":2958},{"type":77},[],{"_uid":3701,"color":2901,"plugin":2902},"22ef8608-e5d5-4064-8bb0-6a61da7acd57",{"_uid":3703,"color":2901,"plugin":2902},"9f7157a2-6775-4531-8b6c-6fa7b351f392","Grid",{"id":3706,"_uid":3707,"body":3708,"images":3755,"headline":46,"text_ref":3756,"component":2639,"sub_title":46,"margin_top":470,"cta_content":3844,"color_border":3845,"headline_tag":46,"in_container":3,"headline_look":2563,"text_placement":46,"headline_weight":187,"color_background":3847,"margin_top_mobile":311,"margin_top_desktop":311},"behandlung","e32d8afe-c068-41ef-8d41-213f4719e0aa",{"type":74,"content":3709},[3710,3715,3719,3723],{"type":318,"attrs":3711,"content":3712},{"level":2665},[3713],{"text":3714,"type":81},"Behandlung der diabetischen Retinopathie ",{"type":77,"content":3716},[3717],{"text":3718,"type":81},"Wie die diabetische Retinopathie behandelt wird, hängt vom individuellen Befund ab. Grundlage der Therapie ist eine optimale Einstellung der Blutzuckerwerte und begleitender Erkrankungen, wie Bluthochdruck oder Fettstoffwechselstörungen. Das fällt in die hausärztliche oder internistische Zuständigkeit. Regelmäßige Kontrollen beim Augenarzt sind jedoch zwingend notwendig, damit ein Fortschreiten der Erkrankung frühzeitig bemerkt wird.  ",{"type":77,"content":3720},[3721],{"text":3722,"type":81},"Im frühen Stadium der diabetischen Retinopathie ist oft noch keine Behandlung erforderlich. Der richtige Zeitpunkt zum Start der augenärztlichen Therapie darf aber nicht verpasst werden. Dann stehen unterschiedliche Behandlungsmethoden zur Verfügung. Der Augenarzt entscheidet im Einzelfall, welche dieser Methoden in Frage kommt. ",{"type":2674,"content":3724},[3725,3735,3745],{"type":2677,"content":3726},[3727],{"type":77,"content":3728},[3729,3733],{"text":3730,"type":81,"marks":3731},"Laserkoagulation",[3732],{"type":326},{"text":3734,"type":81},": Droht das Wachstum neuer Gefäße aufgrund von Sauerstoffmangel in der Netzhaut, kommt diese Form der Lasertherapie zum Einsatz. Durch den Einschuss von bis zu mehreren tausend kleiner Laserherde in die periphere Netzhaut wird ein Teil der Netzhautzellen zerstört. Damit reduziert sich der Gesamtsauerstoffbedarf der Netzhaut. Die übrigen Zellen können dann ausreichend versorgt werden. Laserbehandlungen am Auge sind heute sehr präzise möglich und gelten als schonender Eingriff. ",{"type":2677,"content":3736},[3737],{"type":77,"content":3738},[3739,3743],{"text":3740,"type":81,"marks":3741},"Intravitreale Injektionen",[3742],{"type":326},{"text":3744,"type":81},": Hierbei wird ein Wirkstoff direkt in den Glaskörperraum des Auges gespritzt (IVOM). Dieses Medikament reduziert den Flüssigkeitsaustritt in die Netzhaut und verhindert das so gefährliche Wachsen neuer Gefäße. In der proliferativen Phase der Erkrankung, oder beim Auftreten eines diabetisches Makulaödems wird diese Therapie eingesetzt. Je früher die Behandlung beginnt, desto besser ist die Prognose. Bei schweren Verläufen können auch mehrmalige Injektionen notwendig sein, um das gewünschte Ergebnis zu erzielen. ",{"type":2677,"content":3746},[3747],{"type":77,"content":3748},[3749,3753],{"text":3750,"type":81,"marks":3751},"Augenoperation",[3752],{"type":326},{"text":3754,"type":81},": Kommt es im fortgeschrittenen Stadium der proliferativen diabetischen Retinopathie zu Glaskörperblutungen, liegen starke Traktionsmembranen vor oder droht die Gefahr einer Netzhautablösung, so kann nur mithilfe einer Operation am Auge das Sehvermögen erhalten werden.  ",[],[3757],{"id":46,"_uid":3758,"body":3759,"component":220,"no_margin":3,"margin_top":221},"cd11ff8b-06e6-4e04-8d11-e0c4fa941085",{"type":74,"content":3760},[3761,3769,3776,3783,3800,3817],{"type":318,"attrs":3762,"content":3763},{"level":2665},[3764],{"text":3765,"type":81,"marks":3766},"Il trattamento della retinopatia diabetica",[3767],{"type":138,"attrs":3768},{"color":2808},{"type":77,"content":3770},[3771],{"text":3772,"type":81,"marks":3773},"Il modo in cui viene trattata la retinopatia diabetica dipende dalle circostanze individuali. La base della terapia è il controllo ottimale dei livelli di glucosio nel sangue e di malattie concomitanti come l'ipertensione o i disturbi lipometabolici. La decisione spetta al medico di famiglia o a un internista. Tuttavia, controlli regolari con un oculista sono essenziali per garantire che l'eventuale progressione della malattia sia individuata precocemente.  ",[3774],{"type":138,"attrs":3775},{"color":46},{"type":77,"content":3777},[3778],{"text":3779,"type":81,"marks":3780},"Nello stadio iniziale della retinopatia diabetica spesso non è necessario alcun trattamento, ma non bisogna perdere il momento giusto per iniziare una terapia oftalmologica. I metodi di trattamento possibili sono svariati: spetta all'oculista determinare quale di questi è adatto al singolo caso. ",[3781],{"type":138,"attrs":3782},{"color":46},{"type":2674,"content":3784},[3785],{"type":2677,"content":3786},[3787],{"type":77,"content":3788},[3789,3795],{"text":3790,"type":81,"marks":3791},"Fotocoagulazione laser",[3792,3793],{"type":326},{"type":138,"attrs":3794},{"color":46},{"text":3796,"type":81,"marks":3797},": questo metodo di terapia laser viene impiegato se sussiste il rischio di crescita di nuovi vasi sanguigni a causa della mancanza di ossigeno nella retina. Sparando diverse migliaia di piccoli fasci laser nella retina periferica, alcune delle cellule retiniche vengono distrutte, riducendo il fabbisogno complessivo di ossigeno della retina. Le cellule rimanenti possono così essere adeguatamente approvvigionate. Il trattamento laser dell'occhio è oggi molto preciso ed è considerato una procedura non invasiva. ",[3798],{"type":138,"attrs":3799},{"color":46},{"type":2674,"content":3801},[3802],{"type":2677,"content":3803},[3804],{"type":77,"content":3805},[3806,3812],{"text":3807,"type":81,"marks":3808},"Iniezioni intravitreali",[3809,3810],{"type":326},{"type":138,"attrs":3811},{"color":46},{"text":3813,"type":81,"marks":3814},": questo metodo prevede l'iniezione di un principio attivo direttamente nel corpo vitreo dell'occhio (IVOM). Questo farmaco riduce la fuoriuscita di liquido nella retina e impedisce la pericolosa crescita di nuovi vasi. Questa terapia viene utilizzata nella fase proliferante della malattia o al verificarsi di un edema maculare diabetico. Quanto più precocemente si inizia il trattamento, tanto migliore è la prognosi. Nei casi più gravi, possono essere necessarie più iniezioni per ottenere il risultato desiderato. ",[3815],{"type":138,"attrs":3816},{"color":46},{"type":2674,"content":3818},[3819],{"type":2677,"content":3820},[3821],{"type":77,"content":3822},[3823,3829,3834,3839],{"text":3824,"type":81,"marks":3825},"Chirurgia oculare",[3826,3827],{"type":326},{"type":138,"attrs":3828},{"color":46},{"text":3830,"type":81,"marks":3831},": se nello stadio avanzato della ",[3832],{"type":138,"attrs":3833},{"color":46},{"text":3835,"type":81,"marks":3836},"retinopatia",[3837],{"type":138,"attrs":3838},{"color":2617},{"text":3840,"type":81,"marks":3841}," diabetica proliferante si verificano emorragie vitreali, si riscontrano molte membrane epiretiniche o sussiste il rischio di distacco della retina, la visione può essere preservata solo con l'aiuto della chirurgia.  ",[3842],{"type":138,"attrs":3843},{"color":46},[],{"_uid":3846,"color":46,"plugin":66},"22a26ea2-e08b-41e0-82fc-9ff9b25943ca",{"_uid":3848,"color":46,"plugin":66},"c8d45c03-34a2-4421-9e69-b50636a57357",{"id":3850,"_uid":3851,"body":3852,"image":3858,"cta_ref":3860,"variant":3863,"headline":3864,"text_ref":3865,"component":3891,"cta_label":46,"id_target":46,"image_ref":3892,"margin_top":1324,"headline_ref":3893,"headline_tag":181,"mobile_ratio":3897,"desktop_ratio":46,"headline_look":181,"hide_on_mobile":3,"background_color":3898},"Vorbeugung","d0e9d9ab-1463-4305-93ac-27cac1c1d395",{"type":74,"content":3853},[3854],{"type":77,"content":3855},[3856],{"text":3857,"type":81},"Die regelmäßige Teilnahme an Screening-Programmen für Patienten mit Diabetes mellitus ist vor allem im Hinblick auf die diabetische Retinopathie sinnvoll, die bei regelmäßigen Kontrollen beim Augenarzt frühzeitig erkannt werden kann. Für die Behandlung gilt: Je eher die Diagnose feststeht, desto besser können schwerwiegende Folgen vermieden werden. Diabetiker sollten darauf achten, dass der Diabetes mellitus durch Einhalten einer Diät und regelmäßige Medikamente optimal eingestellt ist. Zudem lassen sich Begleiterkrankungen wie ein erhöhter Blutdruck durch Medikamente gut einstellen, um das Risiko für Netzhauterkrankungen zu reduzieren. ",{"id":25,"alt":25,"name":46,"focus":25,"title":25,"source":25,"filename":46,"copyright":25,"fieldtype":59,"meta_data":3859},{},[3861],{"_uid":3862,"component":525,"cta_label":46,"id_target":46,"cta_variant":46,"cta_target_blank":3},"16133da7-aad3-4d2a-bf7d-6ccbb91c6a58","small","Vorsorgeuntersuchungen sind wichtig! ",[3866],{"id":46,"_uid":3867,"body":3868,"component":220,"no_margin":3,"margin_top":221},"c15208ec-bbc1-4f80-a8fe-0654915be594",{"type":74,"content":3869},[3870],{"type":77,"content":3871},[3872,3877,3882,3887],{"text":3873,"type":81,"marks":3874},"La partecipazione puntuale a programmi di screening per i pazienti affetti da diabete mellito è ",[3875],{"type":138,"attrs":3876},{"color":46},{"text":3878,"type":81,"marks":3879},"particolarmente",[3880],{"type":138,"attrs":3881},{"color":2617},{"text":3883,"type":81,"marks":3884}," utile per quanto riguarda la retinopatia diabetica, che può essere individuata precocemente con controlli regolari dall'oculista. Per quanto riguarda il trattamento, quanto più precoce è la diagnosi, tanto più efficacemente si possono evitare gravi conseguenze. I diabetici devono assicurarsi che il diabete mellito sia sotto controllo seguendo una dieta specifica e assumendo regolarmente i farmaci del caso. Inoltre, i farmaci consentono di controllare efficacemente malattie concomitanti come l'ipertensione arteriosa così da ridurre il rischio di malattie della retina.",[3885],{"type":138,"attrs":3886},{"color":46},{"text":2874,"type":81,"marks":3888},[3889],{"type":138,"attrs":3890},{"color":2958},"Infographic",[],[3894],{"tag":181,"_uid":3895,"look":181,"text":2881,"color":3896,"weight":187,"component":188},"b43bbf7d-85fa-4b9e-9fce-c007c0293125",{"color":46,"plugin":186},"1","#f7f7f7",{"id":3900,"_uid":3901,"body":3902,"images":3905,"headline":3906,"text_ref":3907,"component":2639,"sub_title":46,"margin_top":3913,"cta_content":3914,"color_border":3915,"headline_ref":3917,"headline_tag":181,"in_container":3,"headline_look":181,"text_placement":46,"headline_weight":187,"color_background":3921,"margin_top_mobile":3923,"margin_top_desktop":3923},"faq","b4c27ecd-0533-4995-bde1-ff2f2a169e10",{"type":74,"content":3903},[3904],{"type":77},[],"Häufige Fragen zur diabetischen Retinopathie ",[3908],{"id":46,"_uid":3909,"body":3910,"component":220,"no_margin":3,"margin_top":221},"101b9068-3846-43a8-a277-2d4a9428f74b",{"type":74,"content":3911},[3912],{"type":77},"lg",[],{"_uid":3916,"color":46,"plugin":66},"3a3a9028-66e9-493b-aed5-d0242d3e77fa",[3918],{"tag":181,"_uid":3919,"look":181,"text":2891,"color":3920,"weight":187,"component":188},"3968aebf-e1c4-40ad-b427-40ba281be145",{"color":46,"plugin":186},{"_uid":3922,"color":46,"plugin":66},"b5c85836-d119-4337-9041-b1d6f3e74b93","10",{"id":46,"_uid":3925,"entries":3926,"component":4031,"margin_top":46,"has_link_list":3},"75919b26-404e-4514-8146-fe9965d6ce93",[3927,3964,3995],{"id":46,"_uid":3928,"body":3929,"ctas":3935,"title":3936,"text_ref":3937,"component":3963,"link_title":46},"27de2162-c3d7-4291-a231-c6cb608c69e8",{"type":74,"content":3930},[3931],{"type":77,"content":3932},[3933],{"text":3934,"type":81},"Eine vollständige Heilung der diabetischen Retinopathie ist nicht möglich. Aber: Je früher die Erkrankung erkannt wird, desto eher kann das Fortschreiten der Erkrankung gestoppt werden. ",[],"La retinopatia diabetica è curabile? 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