Diabetic Retinopathy

Introduction

• Diabetic retinopathy is a complication of diabetes and leads to high blood sugar, resulting in retinal disease, which can interfere with its ability to transmit images to the brain through the optic nerve.
• Blood vessels in the retina play an important role in supplying it with oxygen and nutrients, which keep it healthy and working effectively.

Diabetic Retinopathy can result in damage to the blood vessels; these may then bleed, leak or become blocked leading to cell damage in the retina itself.
There are varying forms and levels of severity of diabetic retinopathy – for example, when the retina becomes very damaged, new blood vessels may grow on it and can burst, leading to bleeding and blurred vision. If the macula (the central area of the retina) is affected – this is called Diabetic Maculopathy – the disease has reached a much more advanced and serious stage.
High blood pressure combined with diabetes leads to an even more dangerous condition.

Types of Diabetic Retinopathy

Non Proliferative Diabetic Retinopathy
Generally, this type of diabetic retinopathy does not affect vision because at the initial stage there are just a few enlarged blood vessels, with very minimal bleeding and leaking in the retina.
An examination of the retina by an ophthalmologist will reveal some marks indicating the presence of the condition.
Proliferative Diabetic Retinopathy
This condition can lead to seriously impaired vision as blood vessels grow in the retina and the threat is bleeding from these vessels which can lead to retinal damage, and even to retinal detachment at the back of the eye. Laser treatment is essential to avoid serious long term damage.
Diabetic Maculopathy
Diabetic maculopathy occurs when blood vessels leak into the central area of the retina, which can lead to it swelling and affecting the quality of vision. Laser procedures, injections or surgery are the main treatment options.
Exudates are deposits in the retina from leaky vessels. Haemorrhages in the retina of varying sizes.
Microaneurysms.
Optic Nerve with abnormal new vessels that have bled. Scars from previous laser treatment.
Vitreous haemorrhage in front of the retina.
End stage proliferative Diabetic Retinopathy with fibrousbands.
Retinal Detachment.
Cross sectional scan showing thickening of the macula and exudates.
Exudates (yellow) and haemorrhages in the central retina

Can it be prevented?

Compliance with treatment for diabetes helps control blood sugar levels and blood pressure and so the serious complications of diabetes, including diabetic retinopathy.
Treatment compliance along with regular check ups to monitor blood pressure will help avoid the serious long term effects of diabetes; positive lifestyle choices from balanced diet to regular exercise and not smoking all have a beneficial effect.

What can I do?

Early diagnosis and treatment of diabetes and diabetic retinopathy will generally help prevent serious vision loss for most patients and regular visits to the doctor and ophthalmologist are an essential part of the monitoring process.