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Diabetic Retinopathy

Diabetic retinopathy is a complication of the eye that occurs as a direct result of having diabetes. Diabetic retinopathy occurs when excess sugar in the bloodstream causes blockages to the tiny blood vessels found in the retina. As a result, new, abnormal blood vessels develop. These abnormal blood vessels leak fluid into the eye. Diabetic retinopathy may not present any severe consequences at first, but over time it can result in blindness. The longer an individual has diabetes with uncontrolled blood sugar levels, the greater the risk he or she has of developing this condition.

What are the different types of diabetic retinopathy?

There are two different types of diabetic retinopathy; early diabetic retinopathy and advanced diabetic retinopathy.

Early diabetic retinopathy: Early diabetic retinopathy is the most common form of this condition and is also known as nonproliferative diabetic retinopathy (NPDR). In NPDR, the walls of blood vessels near the retina weaken and sometimes leak fluid and blood. Swollen tissues or leaking vessels affecting the center of the retina called the macula can limit vision. Early diabetic retinopathy can progress into a more severe form as the blood vessels
continue to become blocked.

Advanced diabetic retinopathy: Advanced diabetic retinopathy, also known as proliferative diabetic retinopathy, is the more severe form of this condition. Damaged blood vessels around the retina become completely blocked, resulting in the growth of new abnormal blood vessels. These abnormal blood vessels can bleed into the normally clear vitreous gel creating floaters or blocked vision. The growth of these abnormal blood vessels can also cause the retina to detach from the eye and damage the optic nerve.

What are the symptoms of diabetic retinopathy?

Symptoms of diabetic retinopathy include the following:

  • Blurred vision
  • Impaired color vision
  • Appearance of floaters or spots floating in your vision
  • Loss of vision

How is diabetic retinopathy diagnosed?

Diabetic retinopathy is diagnosed through several types of exams performed by an ophthalmologist.

Dilated Eye Exam: Diabetic retinopathy is most easily diagnosed with a dilated eye exam. Eye drops are administered to dilate the pupils and examine the back of the eye. During this exam, the doctor will look for abnormal blood vessels, retinal detachment, growth of new blood vessels, the presence of scar tissue, vitreous, and abnormalities to the optic nerve. The doctor may also test for glaucoma or look for characteristics of cataracts.

Gonioscopy: This test is used to assess if new diabetic blood vessel in growth is causing glaucoma.

Optical Coherence Tomography (OCT): This test records images of the retina, which are then analyzed to detect any abnormal changes. Such changes include a thinning, thickening or swelling of the retina caused by fluid accumulation. It is a noninvasive test and is also used to monitor the retina during treatment.

Flourescein Angiogram: This test is used to examine the blood vessels of the eye. A colored dye is injected into the vein of the patient’s arm and travels to the blood vessels of the eye. A special camera is used to record images of the blood vessels found near the retina of the eye and will show any abnormalities.

How is diabetic retinopathy treated?

The treatment used for this diabetic retinopathy depends on the type and severity of the condition. Patients with early diabetic retinopathy may not require treatment at first; they may only require routine eye exams to monitor the progression of their condition. In addition, it is recommended that such patients continue to work with their endocrinologist to keep their blood sugar levels low. Controlling blood sugar levels can help to prevent the disease from progressing to the more advanced form. For patients with advanced diabetic retinopathy, several treatment options are available to slow down or stop the progression of their condition. Treatment can be successful in preventing vision loss, as long as the retina has not already been severely damaged. Patients who undergo such treatment still need to see their ophthalmologist regularly to monitor their condition. Other treatments for diabetic retinopathy include:

Injection of Anti-inflammatory Medicine: Injections of anti-inflammatory medicine or anti-VEGF (vascular endothelial growth factor) are sometimes used to shrink abnormal blood vessels.

Scatter Laser Treatment: Scatter laser treatment, also known as panretinal photocoagulation is used to shrink abnormal blood vessels. The retina is treated with scatter laser burns, which cause the abnormal blood vessels to shrink. This procedure is performed in an ophthalmologist’s office and requires at least two sessions to complete. Patients can expect to experience blurred vision for approximately a day after the procedure, as well as some temporary loss of peripheral and night vision.

Focal Laser Treatment: Focal laser treatment, also known as photocoagulation, uses laser burns to slow or stop the leakage of fluid into the eye. This procedure is usually completed in one session in the ophthalmologist’s office.

Vitrectomy: This surgical procedure uses a tiny incision to remove vitreous gel, and possibly blood,from the middle of the eye and scar tissue surrounding the retina. This procedure can also help patients who have suffered a retinal detachment. Since this procedure is surgical, it is performed at either a surgical center or hospital with use of local or general anesthesia.

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