What is Diabetic Retinopathy?
Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in American adults. It is caused by changes in the blood vessels of the retina.
In some people with diabetic retinopathy, blood vessels may swell and leak fluid. In other people, abnormal new blood vessels grow on the surface of the retina. The retina is the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision.
If you have diabetic retinopathy, at first you may not notice changes to your vision. But over time, diabetic retinopathy can get worse and cause vision loss. Diabetic retinopathy usually affects both eyes.
What are the Symptoms of Diabetic Retinopathy?
You might not have symptoms in the early stages of diabetic retinopathy. As the condition progresses, diabetic retinopathy symptoms may include:
1.Spots or dark strings floating in your vision (floaters)
4.Impaired color vision
5.Dark or empty areas in your vision
What are the types of Diabetic Retinopathy?
Diabetic retinopathy is classified into two types:
Non-proliferative diabetic retinopathy (NPDR) is the early state of the disease in which symptoms will be mild or non-existent. In NPDR, the blood vessels in the retina are weakened causing tiny bulges called microanuerysms to protrude from their walls. The microanuerysms may leak fluid into the retina, which may lead to swelling of the macula
Proliferative diabetic retinopathy (PDR) is the more advanced form of the disease. At this stage, circulation problems cause the retina to become oxygen deprived. As a result 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 vessel 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. Glaucoma is an eye disease defined as progressive damage to the optic nerve. In cases of proliferative diabetic retinopathy, the cause of this nerve damage is due to extremely high pressure in the eye. If left untreated, proliferative diabetic retinopathy can cause severe vision loss and even blindness.
What are the risk factors of Diabetic Retinopathy
Diabetes —people with Type 1 or Type 2 diabetes are at risk for the development of diabetic retinopathy. The longer a person has diabetes, the more likely they are to develop diabetic retinopathy, particularly if the diabetes is poorly controlled.
Race—Hispanic and African Americans are at greater risk for developing diabetic retinopathy.
Medical Conditions—persons 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 gestational diabetes develops, the patient is at much higher risk of developing diabetes as they age.
How is Diabetic Retinopathy is diagnosed?
Diabetic retinopathy can be diagnosed through a comprehensive eye examination. Testing, with special emphasis on evaluation of the retina and macula, may include:
Patient History to determine vision difficulties experienced by the patient, presence of diabetes, and other general health concerns that may be affecting vision
Visual acuity measurements to determine the extent to which central vision has been affected
Refraction to determine the need for changes in an eyeglass prescription
Evaluation of the ocular structures, including the evaluation of the retina through a dilated pupil
Measurement of the pressure within the eye
How is Diabetic Retinopathy is treated?
During the first three stages of diabetic retinopathy, no treatment is needed, unless you have macular edema. To prevent progression of diabetic retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol.
Proliferative retinopathy is treated with laser surgery. This procedure is called scatter laser treatment. Scatter laser treatment helps to shrink the abnormal blood vessels. Your doctor places 1,000 to 2,000 laser burns in the areas of the retina away from the macula, causing the abnormal blood vessels to shrink. Because a high number of laser burns are necessary, two or more sessions usually are required to complete treatment. Although you may notice some loss of your side vision, scatter laser treatment can save the rest of your sight. Scatter laser treatment may slightly reduce your color vision and night vision.
Scatter laser treatment works better before the fragile, new blood vessels have started to bleed. That is why it is important to have regular, comprehensive dilated eye exams. Even if bleeding has started, scatter laser treatment may still be possible, depending on the amount of bleeding.
If the bleeding is severe, you may need a surgical procedure called a vitrectomy. During a vitrectomy, blood is removed from the center of your eye.