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Diabetic Retinopathy


What is Diabetic Retinopathy?

Diabetic retinopathy is an eye condition that slowly damages retina, the light sensitive lining at the back of eye. It is a serious sight-threatening complication that occurs to people having diabetes.

This condition usually affects both eyes. The longer a person has diabetes, the more likely they will develop diabetic retinopathy. If left untreated, diabetic retinopathy can cause blindness.

Symptoms of diabetic retinopathy include:

  • Seeing spots or floaters
  • Blurred vision
  • Having a dark or empty spot in the center of your vision
  • Difficulty seeing well at night

Risk factors for diabetic retinopathy include:

  • Diabetes: People having type 1 or type 2 diabetes are at higher risk of developing diabetic retinopathy. The longer a person have diabetes, greater are chances of developing diabetic retinopathy, specially if the diabetes is poorly controlled.
  • Race: Hispanics and African Americans are at greater risk for developing diabetic retinopathy.
  • Medical conditions: People with other medical conditions, such as high blood pressure and high cholesterol, are at greater risk.
  • Pregnancy: Pregnant women face a higher risk for developing diabetes and diabetic retinopathy. If a woman develops gestational diabetes, she has a higher risk of developing diabetes as she ages.

What Causes Diabetic Retinopathy?

Diabetes damages blood vessels in retina, these blood vessels leaks blood and other fluids, which cause swelling in tissues causing blurred visions. These fluids can leak into the macula (small part of retina that allow us to see colors and fine details) which causes it to swell, resulting in blurred vision. In an attempt to improve blood circulation in the retina, new blood vessels may form on its surface. These fragile, abnormal blood vessels can leak blood into the back of the eye and block vision.

Types of Diabetic Retinopathy?

Diabetic retinopathy is classified into two types:

  • Non-proliferative diabetic retinopathy (NPDR): NPDR is the early stage of the disease in which symptoms will be mild or nonexistent. In this, the blood vessels in the retina are weakened and tiny bulges in the blood vessels, called microaneurysms, may leak fluid into the retina. This leakage may lead to swelling of the macula.

  • Proliferative diabetic retinopathy (PDR): PDR is the more advanced form of the disease. At this stage, circulation problems deprive the retina of oxygen. To improve blood circulation new, fragile blood vessels can begin to grow in the retina and into the vitreous, the gel-like fluid that fills the back of the eye. The new blood vessels may leak blood into the vitreous, clouding vision.
Other complications of PDR include detachment of the retina due to scar tissue formation and the development of glaucoma.

How is diabetic retinopathy diagnosed?

Diabetic Retinopathy can be diagnosed through a comprehensive eye examination which evaluates retina and macula. This may include:

  • Patient history to determine vision difficulties, presence of diabetes, and other general health concerns that may be affecting vision

  • Visual acuity measurements to determine how much central vision has been affected

  • Refraction to determine if a new eyeglass prescription is needed

  • Evaluation of the ocular structures, including the evaluation of the retina through a dilated pupil

  • Measurement of the pressure within the eye

Supplemental testing may include:

  • Retinal photography or tomography to document current status of the retina

  • Fluorescein angiography to evaluate abnormal blood vessel growth

How is diabetic retinopathy treated?

Treatment of Diabetes retinopathy depends on the stage of the disease and is accordingly treated with an aim to slow or stop the progression of disease. In early stage or Non-proliferative diabetic retinopathy regular monitoring along with light exercise and proper diet may be the only treatment required. If disease advances, the blood vessels may leak blood and fluid in retina causing damage to the macula. To stop the leakage Laser treatment (photocoagulation)is carried out in which laser beam of light creates small burns in areas of the retina with abnormal blood vessels to try to seal the leaks.

In Proliferative Diabetic Retinopathy, widespread of blood vessels in retina can be treated by creating a pattern of scattered laser burns in retina, causing abnormal blood vessels to shrink and eventually disappear. In this process, some side visions may be lost to protect central vision.