Understanding Diabetic Retinopathy
What is diabetic retinopathy?
Diabetic retinopathy (DR) is a term that encompasses multiple disorders of the retina, the light-sensitive area in the back of the eye, which can cause vision loss and blindness in people who have diabetes.
High blood sugar levels in patients with diabetes cause damage throughout the body, including to blood vessels in the retina, resulting in progressive loss of vision if left untreated. The longer you have diabetes and the less controlled your blood sugar is, the more likely you are to develop diabetic retinopathy, as long periods of high blood sugar lead to the accumulation of fluid in the blood vessels, causing blockages or leaks that affect vision. However, with controlled blood sugar and regular checkups, most patients with diabetes will not develop more than minor eye disorders.
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DR is divided into two major types - nonproliferative (NPDR) and proliferative (PDR). In NPDR, there are mild or no symptoms as this is the early stage in which the blood vessels start to weaken and form microaneurysms (tiny bulges in the blood vessels) that could leak fluid into the retina. PDR is the more advanced stage of the disease in which vision loss begins as the retina’s circulation fails to provide oxygen, and fragile new blood cells can begin to grow and may leak.
How can people with diabetes know if they are developing DR?
People with diabetes should be getting a retinal screen once a year, even if they are not showing symptoms of affected vision. These symptoms can include “seeing spots or floaters, blurred vision, having a dark or empty spot in the center of your vision, (and/or) difficulty seeing well at night” (American Academy of Ophthalmology). The sooner that diabetic retinopathy is diagnosed, the more likely that available treatments will be successful.
What treatments are available for DR?
The types of treatment vary depending on the stage of the disease, the goal being to stop or at least slow the disease’s progression. The way to maintain the health of your eye’s blood vessels starts at controlling blood sugar levels, through diet and/or prescribed medication. In the early non-proliferative stages, the only action may be regular monitoring.
For proliferative retinopathy, however, photocoagulation (laser treatment) may be a viable solution. Laser beams can be used for burning small areas in the retina which have abnormal blood vessels in an attempt to seal leaks and discourage the formation of additional abnormal vessels with the goal of reducing swelling in the retina. Sometimes, the treatment may need to be repeated. A vitrectomy is a surgery that is only recommended for patients with advanced PDR. Here, the surgeon removes vitreous gel and blood (and sometimes scar tissue) from the retina’s leaking vessels, allowing light rays to focus again properly.