Diabetic retinopathy is one of the most serious complications to affect diabetics. The cause for its gravity is simple: it can lead to blindness.
This is why awareness and management of diabetic retinopathy are vital for those who have diabetes. This helps them recognise the early stages of diabetic retinopathy and take steps to reduce the risk of its progression or development.
Today, we’ll help you understand diabetic retinopathy, covering everything from its causes to the best ways to manage it.
What is Diabetic Retinopathy?
Diabetic retinopathy is a condition that affects the retina, the delicate light-sensitive layer of tissue at the back of the eye. For people with diabetes, the blood vessels of the retina can start to get occluded and develop abnormalities.
The vessels may develop microaneurysms, for example, or small bulges. There may also be bleeding spots or haemorrhages on the retina.
In the late stages of diabetic retinopathy, growth of abnormal new blood vessels can occur. Unfortunately, these vessels are fragile and prone to bleeding.
All these complications can lead to bleeding in the vitreous cavity (the compartment in the back of the eye). This can impede vision and lead to tractional retinal detachment.
The latter is because the blood vessels can even cause the formation of scar tissue when they heal after a breakage. The tissue takes up space, forcing the retina to separate from the back of the eye.
In the terminal stages, the condition can even progress into severe glaucoma, which can result in vision loss and pain.
Causes of Diabetic Retinopathy
The primary cause of diabetic retinopathy is long-term poorly controlled diabetes. The problem comes from chronically high blood sugar levels and the damage this causes to the tiny blood vessels in the retina.
We’re still uncertain of the exact way high blood sugar leads to issues for these vessels. However, we do know that it’s associated with lowered oxygen delivery.
This suffocates the eye and causes the release of growth factors in the eye that encourage new blood vessels to grow. However, these new blood vessels are abnormal and dangerous. They damage the eye in ways mentioned earlier.
People with all types of diabetes are at risk for diabetic retinopathy, so whether a patient has Type 1 or Type 2 diabetes does not matter. Moreover, the longer you have had diabetes, the higher your chances of having the condition.
There are other risk factors worth noting too: high blood pressure, high cholesterol levels, and genetics.
Types of Diabetic Retinopathy
Generally speaking, there are two types of diabetic retinopathy. The first is non-proliferative diabetic retinopathy (NPDR). The second is proliferative diabetic retinopathy (PDR).
1. NPDR
Typically, this is diabetic retinopathy that has not yet reached the point of abnormal new blood vessel growth (or proliferation) in the retina. It may be split further into other types according to severity.
At its mildest, the retina can appear mostly healthy and patients have no symptoms. They may only have a microaneurysm or two in the retinal blood vessels.
At worst, there can be widespread bleeding within the retina. This can still cause problems, as the bleeding can put pressure on the optic nerve.
2. PDR
A patient has progressed to PDR when blood vessels have begun to grow throughout the retina or blood has already found its way to the vitreous cavity.
This is the last, most severe stage of the disease. In some cases, the bleeding from the abnormal vessels may be severe enough to occlude large parts of one’s vision.
This is because the blood starts to block the light entering the eye. This is also why one of the common side effects of diabetic retinopathy is seeing floaters. These dark shapes floating in your vision are actually signs of blood blocking light in the eye.
Management and treatment options
As we noted earlier, diabetic retinopathy can lead to vision loss. Some of this vision loss can be irreversible.
Fortunately, acting as soon as possible can prevent worse vision loss. In fact, it can even reduce the risk of going blind by 95%. This is why treatment is advised as soon as possible.
Treatments for diabetic retinopathy
Below are some of the options available to people with the disease:
- Laser treatment – Using lasers for the treatment of proliferative diabetic retinopathy has been the mainstay for decades. A laser is used to achieve panretinal photocoagulation. This helps prevent the growth of the abnormal and fragile vessels.
- Injections – Anti-VEGF (vascular endothelial growth factor) injections can help manage diabetic retinopathy and reduce swelling. The injections stop the abnormal blood vessels from leaking fluid, growing, and bleeding under the retina.
- Eye surgery – Surgeries like vitrectomy are sometimes necessary for advanced cases. They are typically advised if there is extensive bleeding in the eye or if the patient has started to develop retinal detachment.
Management tips for diabetic retinopathy
Managing diabetes is the best way to lower the risk of diabetic retinopathy. With good sugar control, it’s possible to reduce the chances of it progressing to a more severe stage even once you already have it.
The usual advice applies here: lifestyle changes like regular meals and a healthy diet can do a lot to control blood sugar. The same goes for exercise and performing maintenance treatment for things that are added risk factors, like hypertension.
Moreover, those with diabetes should have a regular appointment with their eye specialist. Even if there is no diabetic retinopathy at this moment, an annual check is still necessary.
Such examinations can help you pick up on issues before they become severe. Early detection is the best way to avoid the worst outcome of this disease.
Book an appointment to check for diabetic retinopathy today
Diabetic retinopathy is a serious disease with potentially grave outcomes, and it’s important for diabetics to be on the lookout for its symptoms.
Eye doctors like ours at Shinagawa Eye Centre can help you identify this disease as well as manage it. For best results, you should get regular eye examinations in order to find and address these conditions early on.
Call us to enquire or book an appointment for assessment as soon as possible. If you do have diabetic retinopathy, we can go over your management and treatment options with you.
