Understanding Diabetic Retinopathy: Causes, Symptoms, and Management

What is it?

Diabetic retinopathy is an eye condition in which the retina, the layer that translates the image you are seeing into electrical impulses to the brain, is damaged due to diabetes mellitus. Diabetic retinopathy can appear if you have uncontrolled type 1 or 2 diabetes for a long time. It is actually the leading cause of blindness in developed countries. Diabetic retinopathy is caused due to damage to the small blood vessels and neurons of the retina, leading to reduced blood flow. There are two types of diabetic retinopathies;
1. Nonproliferative diabetic retinopathy (NPDR)-
This is the first stage of diabetic retinopathy. It means that your retina isn’t growing new blood vessels. In some cases, the center of the retina (called macula) begins to swell, causing macular edema.
2. Proliferative diabetic retinopathy (PDR)
As the disease progresses, due to the reduced blood flow, your retina grows new blood vessels. These are abnormal blood vessels growing in abnormal locations. These abnormal blood vessels tend to bleed, cloud vision, and harm the retina.

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Additional names

This group contains additional names:
- Diabetic Eye Disease (DED)

Signs & symptoms

The symptoms depend on the type and the severity of the retinopathy. NPDR (Nonproliferative diabetic retinopathy) is usually asymptomatic other than in cases where macular edema develops, in which case blurry or poor vision is usually present. In PDR (Proliferative diabetic retinopathy), abnormal fragile new blood vessels form. These vessels tend to bleed and cause blurred vision or spots floating in the visual field. These may eventually lead to blindness.

Diagnosis

Diabetic retinopathy can be detected by a fundus examination performed by an ophthalmologist. During this examination, the doctor will apply eye drops that dilate your pupils.

Fundus photography is usually performed in order to document and enable good follow up of your retina.
Fluorescein angiography, a technique used for examining the blood circulation of the retina, is often used to detect blocked retinal blood vessels.
Optical Coherence Tomography, a technique that gives a high resolution image of the retina, is sometimes used to determine the retina’s thickness and to show areas of fluid accumulation.

Treatment

Since diabetic retinopathy develops in people with longstanding poor treated diabetes mellitus, the best option is prevention. Thus, if you have diabetes, it is essential to treat the diabetes well and avoid periods of uncontrolled diabetes.
Diabetic retinopathy cannot be cured. The treatment is aimed at slowing deterioration.
If you are diagnosed with non proliferative diabetic retinopathy, treatment is usually limited. However, close management of your diabetes can help slow progression. Sometimes multivitamins are also recommended.
Proliferative diabetic retinopathy is usually treated with one or more of the following:
1. Laser- the laser destroys abnormal new vessels.
2. Injections of corticosteroids or anti-VEGF (Vascular endothelial growth factor) agents into the eye- these agents reduce the growth of new abnormal blood vessels.
3. Vitrectomy- People who have a large amount of blood in their vitreous ( the clear gel that fills the eyeball) can profit from a vitrectomy surgery. During this procedure, the bloody vitreous is replaced by clear saline, improcing vision.

☝️ This is not a substitute for professional medical advice. Please consult with your physician before making any medical decision.

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Source of Information - We analyze big data of more than 23 million patients de-identified medical records from the following sources:

National Institution of Health ∙ World Health Organization ∙ University of Illinois hospital