Diabetic Retinopathy
Diabetic Retinopathy is one of the most common complications of long-term diabetes and a leading cause of blindness worldwide. In Diabetic Retinopathy, small blood vessels supplying the retina are either directly damaged or remodelled, which results in leakage of fluid, proteins, and other debris into the retina and may result in permanent vision loss if left untreated.
Diabetic retinopathy is the leading cause of blindness in people of working age in industrialised countries.
The best predictor of diabetic retinopathy is the duration of the disease.
After 20 years of diabetes, nearly 99% of patients with type 1 diabetes and 60% with type 2 have some degree of diabetic retinopathy.
33% of patients with diabetes have signs of diabetic retinopathy.
Are you at high risk of Diabetic Retinopathy?
As the name suggests, individuals who are suffering from type 1 or type 2 diabetes are prone to Diabetic Retinopathy. Studies have indicated that a longer duration of diabetes will result in a greater risk of developing this serious eye complication.
Other factors, which are likely to play role in the development of Diabetic Retinopathy are:
High levels of blood glucose.
High blood pressure.
Elevated cholesterol.
Pregnancy.
Clinical trials have shown that having good control over glucose level and maintaining blood pressure reduces the risk of development and progression of Diabetic Retinopathy.
What are the symptoms of Diabetic Retinopathy?
Patients might not experience symptoms until the disease has advanced to the stage where treatment may be ineffective. If Diabetic Retinopathy is detected and treated properly at early stages, vision loss over time can be reduced, improving the quality of life for the patient and preventing the financial burden which might result due to visual impairment.
The progression of the disease might lead to the following symptoms:
Blurred vision.
Sudden loss of vision in one or both eyes.
Difficulty reading or seeing detailed work.
Floaters that drift through your field of vision.
Why you should get screened for Diabetic Retinopathy?
As patients with Diabetic Retinopathy are unaware of the disease until it progresses to the advanced stage, screening is an important tool to diagnose it early. With proper patient management, early diagnosis can prevent serious complications.
Only about 60% of people with diabetes have recommended yearly screenings for diabetic retinopathy. It is recommended that people with type 1 diabetes should have annual screenings beginning 5 years after the onset of their disease, whereas those with type 2 diabetes should have an immediate screening at the time of diagnosis and with yearly follow up afterward.
As Diabetic Retinopathy can progress rapidly during pregnancy, it is recommended that pregnant women with diabetes have a dilated eye exam prior to conception, early in the first trimester, and a follow up every 3 months until delivery.
What is the treatment and management of diabetic retinopathy?
During visual complications of diabetic retinopathy, the main goal is to preserve the visual function, improve the vision-related quality of life, and control the blood glucose and cholesterol levels. Blood pressure management has also been shown to decrease disease progression and patients should be counseled to stop smoking.
The main treatments which can be provided in the case of diabetic retinopathy include:
Intravitreal injections; medications injected into the retina.
Laser treatment.
Vitrectomy; a procedure in which vitreous gel and hemorrhage are removed from the eye.
Clinical trials for using stem cell therapy for diabetic retinopathy are also underway.
Because patients with diabetes may be under the care of multiple practitioners, effective communication and care coordination is necessary to optimise care.
