Diabetic retinopathy is an affection of diabetes to the retina. It is a micro-angiopathy affecting small blood vessels . pathology takes place in main two events.
a) Microvascular occlusion
Factors-
-Thickening of capillary basement membrane and endothelial damage.
-Defective RBC – defective O2 transport
-Aggregation of platelates.
Due to above factors retinal ischaemia leads to retinal hypoxia. IT LEADS TO-
-Release of vasopromotive substance causes neovascularisation of retina and iris
-Arterio nenous shunts
b) microvascular leakage
Aneurysm and above mentioned factors of microvascular occlusion cause micropvascular leakage.
Events occured -
Loss of pericytes .
Weakening of vessel wall.
Leakage out pouching – retinal oedema.
Microaneurysm formation.
Rupture.
Haemorrhages.
Classification according to modern-
1. Background diabetic retinopathy.
2. Diabetic maculopathy.
3. Pre-proliferative diabetic retinopathy.
4. Proliferative diabetic retinopathy.
5. Advanced diabetic retinopathy.
Clinical features-
Loss of vision (irreversible).
Small dot and blot haemorrhages.
Hard exhudates may or may not involve macular area.
Ayurvedic approach
Dosha- pitta kapha
Dushya -raktha rasa
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Aam produced due to Agnimaandya and Kaphakar aahar vihar leads to dushti of rasa and kapha(kapha is mala of rasa).sansarg of kapha and raktha deviates pitta (mala of raktha). These ALL GET STHANSANSHRAYIT AT NETRA .AS-
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Moreover Matra vat vruddhi of raktha occurs and sukshma strotas located at netra get dusht
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‘Gati’of vata is been obstructed by kapha and pitta at small blood vesels which leads to vata prakop at sira and sira shaithilya occurs. Vatga deviated by specially by Khara and Ruksha guna , thus blood vessels get fragile and exhudation and haemorrhage takes place i.e. vimarggamanam of kapha and rakyha.
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As per reference in samhita we can count it as Urdhwang raktha-pitta.
When matravat vruddhi of raktha takes place prakupit pitta get sthan-sanshryit at abhishyandi and guru strotas (openings of sukshma strotas).