Diabetic Retinopathy
Reviewed by Michael Fu, OD
What is Diabetic Retinopathy?
Diabetic Retinopathy is yet another problem faced with those people who have diabetes. Diabetes damages tiny blood vessels inside the retina causing degradation. As diabetic retinopathy becomes more severe, new blood vessels begin to form on the retina that could break and cause severe vision loss. The disease is usually un-noticed, but as more and more blood vessels are damaged and new ones are formed, the higher the chances of vision loss. It is recommended that people with diabetes get a thorough eye examination once a year.
Stages of Diabetic Retinopathy
- Mild Non-proliferative Retinopathy - Microaneurysms, small swellings in the retina's tiny blood vessels, form
- Moderate Non-proliferative Retinopathy - Essential blood vessels become blocked
- Severe Non-proliferative Retinopathy - Even more blood vessels are blocked in the retina , and the retina senses the need for new blood vessels to grow and supply oxygen
- Proliferative Retinopathy - Growth of abnormal blood vessels on the retina that could leak and cause severe damage.
- * - At any stage, fluid can leak into the macula, a small and highly sensitive part of the retina, and cause blurred vision. This is known as macula edema and is actually one of the most common causes of vision loss in diabetic patients.
Symptoms and Detection
Diabetic Retinopathy has no early warning signs because vision loss is not noticed until damage has occurred. At the stage of proliferative retinopathy, specks of blood can be seen which lead to blurred vision. A dilated eye exam uses drops to widen the pupils to allow an eye care professional to check the retina, blood vessels and optic nerves for changes. A fluorescein angiogram uses a special dye that is injected into the body and tracked and photographed as it flows through the retina and its blood vessels to spot leaking blood vessels.
Treatment and Prevention of Diabetic Retinopathy
Macula edema may be treated with a process called focal laser photocoagulation, where hundreds of small laser burns are sent to specific areas of leakage around the macula in order to slow and reduce leaking in the retina. Sometimes more than one treatment is needed and according to the NEI, "Focal laser treatment stabilizes vision and in fact, focal laser treatment reduces the risk of vision loss by 50 percent. In a small number of cases, if vision is lost, it can be improved." Proliferative Retinopathy may treated with laser photocoagulation as well. Laser burns are used to seal off leakage and shrink leaking blood vessels. Vision is saved but lost vision is not restored by this process. That is why it is important to get annual exams to prevent the disease from entering this stage. If blood leakage is severe, a vitrectomy may be used to clear out blood that has leaked into the vitreous humor. In this procedure, a small incision is made in the eye and vitreous gel that has been contaminated with blood is removed and filled with a saline solution. Prevention of Retinopathy is the first step. It is a good idea to get annual eye exams. Some other steps that may help include keeping blood sugar values moderate, keeping blood pressure at normal values, eating healthy diets with normal amounts of cholesterol and exercising to keep the body healthy.
For more information or your particular situation ask your eye care doctor or visit http://www.nei.nih.gov for more research. Materials on this page have been researched from the national Eye Institute.
[Page updated 12/2010]
