What is diabetic retinopathy?
Diabetic retinopathy involves a degeneration of the retinal blood vessels in people with poorly controlled diabetes. It occurs when excessive sugar in the blood damages the small vessels that provide nutrients and oxygen to the retina, a sensory tissue in the back of the eye that captures visual signals before transmitting them to the brain. Diabetic retinopathy is a leading cause of blindness in developed countries.
What are the risk factors for diabetic retinopathy?
Several factors cause diabetic retinopathy and can accelerate its progression:
- Longer duration of diabetes
- Poor diabetic control
- High blood pressure
What are the different types of diabetic retinopathy?
Non-proliferative retinopathy is the most common and less serious form; it accounts for 80% of all cases. There can be small blood vessel dilations and scattered bleeding spots within the retina.
Proliferative diabetic retinopathy is characterized by ischemia (significant decrease in blood supply of oxygen) and the subsequent growth of abnormal and fragile vessels. Severe bleeding inside the eye can occur.
What are the symptoms of diabetic retinopathy?
Non-proliferative retinopathy often does not result in decreased vision unless fluid accumulates in the macula region (macular edema).
In proliferative retinopathy, vision loss is often slowly progressive but can be more sudden from bleeding inside the eye (vitreous hemorrhage) and/or retinal detachment.
What are the available treatments of diabetic retinopathy?
Diabetic retinopathy can be detected early and treated appropriately.
The majority of cases of non-proliferative diabetic retinopathy do not require treatment other than a good control of blood sugar and pressure. However, if vision is impaired by macular edema, localized laser treatment and / or anti-VEGF injections may be required. Both the laser and the injections aim to seal the problematic blood vessels and prevent leakage.
When damage is more extensive, pan-retinal laser photocoagulation (PRP) or a wider laser is required. The PRP causes a regression of abnormal vessels, effectively controlling the damage, but can lead to a decrease in peripheral vision and night vision.
In the cases of persistent vitreous hemorrhage accompanying proliferative diabetic retinopathy, vitrectomy may be indicated. This surgical procedure involves removal of the vitreous body and application of laser treatment of the retina.
What are some common tips for patients with diabetes?
- Consult an eyecare professional annually
- Control blood sugar
- Control blood pressure
- Quit smoking