Diabetic Retinopathy
What is Diabetic Retinopathy?
Diabetic retinopathy is an eye disease that affects the light sensitive retina tissue at the back of the eye. High blood sugar levels cause damage to blood vessels in the retina. The disease leads to blurry vision, vision distortion and possibly blindness.
Types of Diabetic Retinopathy
NPDR (non-proliferative diabetic retinopathy): This is the earliest stage of the disease. The tiny blood vessels within the retina leak fluid and make the retina swell (called macular edema). The blood vessels can also close off (called macular ischema). When that happens, blood cannot reach the macula. With both, your vision can be affected.
PDR (proliferative diabetic retinopathy): This is the more advanced stage of the disease. When this happens, new (weak) blood vessels actually grow on the retina or optic nerve (neovascularization). These weak vessels can rupture and bleed into the clear center of the eye. This can blur vision by blocking light from reaching the retina. Long-term bleeding can cause the retina to pull away from the wall of the eye (retinal detachment). If this happens, the result is severe vision loss.
Risk Factors
- Anyone with diabetes is at risk-both Type I and Type II. The longer someone has diabetes, the more likely they will get diabetic retinopathy.
Symptoms
- Blurry vision
- Vision changing from blurry to clear
- Increased number of floaters
- Vision loss
How is Diabetic Retinopathy Diagnosed?
Your ophthalmologist will do a dilated eye exam to see the inside of your eye. Your doctor may also do a FA (fluorescein angiography). With an FA, fluorescein is injected into a vein so that it can travel through your blood vessels. Photos are taken with a camera as the dye travels throughout your system. This can show if any blood vessels are blocked or leaking fluid. Another test called an OCT (ocular coherence tomography) may be done. During an OCT, a machine scans the retina and shows detailed images of its thickness.
Treatment
Treatment is based on what your ophthalmologist sees.
- The best treatment is prevention-keeping your blood sugar under control. Even when retinopathy is diagnosed, early treatment can preserve your vision.
- Anti-VEGF medication injections can help to reduce swelling of the macula which slows vision loss and possibly improve vision.
- Laser surgery may be used to seal the leaking blood vessels for patients with macular edema.
- In advanced cases of PDR, vitrectomy surgery may be recommended. This removes vitreous gel and blood from leaking vessels in the back of the eye which allows light rays to focus properly on the retina.
