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Diabetic Retinopathy

Diabetic Retinopathy
in Ophthalmology

Apr 19, 2022

Diabetic retinopathy is one of the leading causes of vision loss amongst diabetics. It is caused by damage to the blood vessels of retina (light sensitive tissue layer at the back of eye). These blood vessels can swell and leak or they can close stopping blood from passing through. Sometimes abnormal new blood vessels grow on the retina. All of these changes can steal your vision.

There are two main stages of diabetic eye disease.

  1. NPDR (Non-proliferative diabetic retinopathy)
  2. PDR (Proliferative Diabetic retinopathy)

NPDR (Non-proliferative diabetic retinopathy)

This is the early stage. When macula (most sensitive and important part of retina) swells, it is called macular edema. This is the commonest reason for vision loss. Sometimes tiny deposits called exudates can also from in the retina affecting vision too.

PDR (Proliferative Diabetic retinopathy)

This is the more advanced stage of diabetic eye disease. In this stage, abnormal blood vessels start growing in the retina called neovascularization. These new vessels are fragile and often bleed into the vitreous. If they only bleed a little, you might see a few dark floaters. If they bleed a lot, it might block all vision. These new blood vessels can form scar tissue which can contract and lead to detached retina. PDR is very serious and can affect both your control and peripheral (side) vision.

Sign and Symptoms

Patient may not have any eye symptoms even till later stages of disease it macula is not involved. However, few patients may have symptoms like –

  • Blurred Vision.
  • Impairment of color vision.
  • Floaters or transparent and colourless spots and dark strings that float in the field of vision.
  • Patches or streaks that block the person’s vision.
  • Poor night vision.
  • Sudden and total loss of vision.

Risk Factors

  • Uncontrolled / Poor control of diabetes.
  • Longer duration of diabetes.
  • High blood pressure and high cholesterol.

Diagnosis: Diabetic retinopathy may not cause any noticeable change in vision in early stages, so every diabetic needs to be screened for it by doing regular dilated fundus examination. If diabetic retinopathy changes are noticed then doctor might perform few other investigations like OCT (Optical Coherence Tomography) or FFA (Fluorescein Angiography) to check the retina in detail and know the stage of disease.

If patient has no signs of diabetic retinopathy then, regular yearly fundus examination is enough or as advised by your eye doctor.

TREATMENT:

  • Good and strict control of blood sugar, blood pressure, cholesterol levels.
  • Laser treatment.
  • Intraocular injections to reduce the macular edema.
  • Surgery in very advanced cases of PDR.

Remember vision loss in Diabetics is preventable by regular eye examination including dilated fundus examination as advised by your eye doctor.

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