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Incidence of Diabetic Retinopathy |
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14
million diabetics risk loss of sight without early
treatment. Bleeding in the retina is a frequent
cause of blindness in diabetic patients aged 20-64
years.
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Definition
of Diabetic Retinopathy |
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If you
have diabetes mellitus, your body does not use
and store sugar properly. High blood-sugar levels
can damage blood vessels in the retina, the nerve
layer at the back of the eye that senses light
and helps to send images to the brain. The damage
to retinal blood vessels is referred to as diabetic
retinopathy. The disorder usually occurs in both
eyes. These changes may include microaneurysms,
retinal hemorrhage, macular edema, development
of new and leaky blood vessels, and vitreous hemorrhages
etc. Diabetic retinopathy can seriously affect
vision and, if left untreated, cause blindness.
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Symptoms
of Diabetic Retinopathy |
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Often
there are no symptoms in the early stages of the
disease. Vision may not change until the disease
becomes severe. There is no pain either. Blurred
vision may occur when the macula swells from the
leaking fluid. If new vessels have grown on the
surface of the retina, they can bleed into the
eye, blocking vision. However, even in more advanced
cases, the disease may progress a long way without
symptoms. |
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Types
of Diabetic Retinopathy |
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In
a very broad sense, there are two types of diabetic
retinopathy:
- Non-proliferative diabetic
retinopathy (NPDR)
- Proliferative diabetic retinopathy
(PDR)
NPDR,
commonly known as background retinopathy,
is an early stage of diabetic retinopathy.
In this stage, tiny blood vessels within
the retina leak blood or fluid. The leaking
fluid causes the retina to swell or to form
deposits called exudates. The beginning
stages of diabetic retinopathy may cause
blurriness in your central or peripheral
(side) vision, or it may produce no visual
symptoms at all. It mainly depends on where
the blood vessel changes are taking place
in your retina. Many people with diabetes
have mild NPDR, which usually does not affect
their vision. When vision is affected it
is the result of macular edema and / or
macular ischemia. Macular
edema is swelling,
or thickening, of the macula, a small area
in the center of the retina that allows
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| Early
Diabetic Retinopathy with Microhemorrhages |
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you to see fine details
clearly. The swelling is caused by fluid
leaking from retinal blood vessels. It
is the most common cause of visual loss
in diabetes. Vision loss may be mild to
severe, but even in the worst cases, peripheral
vision continues to function. Macular
ischemia occurs when small blood
vessels (capillaries) close. Vision blurs
because the macula no longer receives
sufficient blood supply to work properly.
PDR is present
when abnormal new vessels (neovascularization)
begin growing on the surface of the retina
or optic nerve. The main cause of PDR
is widespread closure of retinal blood
vessels, preventing adequate blood flow.
The retina responds by growing new blood
vessels in an attempt to supply blood
to the area where the original vessels
closed. Unfortunately, the new, abnormal
blood vessels do not re-supply the retina
with normal blood flow. The new vessels
are often accompanied by hemorrhage, scar
tissue that may cause wrinkling or detachment
of the retina. PDR may cause more severe
vision loss than NDPR because it can affect
both central and peripheral vision.
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| Retina with Early PDR |
Retina with Advanced PDR |
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If you have diabetes
this does not necessarily mean that your
sight will be affected, but there is a higher
risk. If your diabetes is well controlled
then you are less likely to have problems,
or they may be less serious. Evidence also
suggests that such factors as pregnancy,
high blood pressure and smoking may cause
diabetic eye disease to develop or worsen.
As a diabetic, or a person at risk, it is
important that you take steps to help prevent
the development of diabetic retinopathy
by taking your prescribed medication as
instructed; following a proper diet; exercising
regularly; and having your eyes examined
regularly. By doing so, chances are good
that you can enjoy a lifetime of good vision
and health.
Remember that
if your vision is getting worse, this does
not necessarily mean you have diabetic retinopathy.
It may simply be a problem that can be corrected
by glasses.
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Detection
of Diabetic Retinopathy |
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Since
this disease can cause blindness, early diagnosis
and treatment is essential. If you have diabetes
or you have a family history of diabetes, you
should have your eyes examined at least once a
year by an ophthalmologist. During a thorough,
comprehensive
eye examination, your doctor gets
to know you, your family history, your lifestyle
and your vision needs. Your eyes will be dilated
during the exam. To detect diabetic retinopathy,
your ophthalmologist looks inside your eyes with
an instrument called an ophthalmoscope.
The interior of your eyes may also be photographed
to monitor the progression of disease. |
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Treatment
of Diabetic Retinopathy |
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The
best treatment is to prevent the development of
retinopathy as much as possible. Strict control
of your blood sugar will significantly reduce
the long-term risk of vision loss from diabetic
retinopathy. If high blood pressure and kidney
problems are present, they need to be treated
as well.
Your ophthalmologist may suggest laser surgery
in which a strong light beam is aimed onto the
retina to shrink the abnormal vessels. Laser surgery
has been proved to reduce the risk of severe vision
loss from this type of diabetic retinopathy by
60 percent. If you have macular edema, laser surgery
may also be used. In this case, the laser beam
is used to seal the leaking blood vessels. Multiple
laser treatments over time are sometimes necessary.
However, laser surgery often cannot restore vision
that has already been lost. That is why finding
diabetic retinopathy early is the best way to
prevent vision loss.
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Prevention
of Diabetic Retinopathy |
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If
you have diabetes, it is important to know that
today, with improved methods of diagnosis and
treatment, only a small percentage of people who
develop retinopathy have serious vision problems.
Early detection of diabetic retinopathy is the
best protection against loss of vision. You can
significantly lower your risk of vision loss by
maintaining strict control of your blood sugar
and visiting your ophthalmologist regularly.
If you are concerned about diabetic retinopathy
and would like to schedule an eye appointment
with NeoVision Eye Center, please contact us at
510-431-5511
(Union City)
or 650-962-4626(Mountain
View). |
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