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Diabetic Retinopathy

Diabetic Retinopathy


The Retina is the innermost layer of the eye and it receives the light rays entering it. The retina contains a nerve called the optic nerve that sends and receives messages from the brain.

The Macula is a small portion of the retina that specializes for seeing fine details. It is responsible for the sharp vision of the eye that is required for reading, writing and differentiating colors.

What is Diabetic Retinopathy?

It is, as the name suggests, an eye complication caused by diabetes. Diabetic Retinopathy includes all the diseases that affect the retina, the light-sensitive part of the eye, caused by diabetes.

Diabetes can cause eye problems that can lead to blindness as it affects the retina mostly. Patients suffering from diabetes have a higher risk of blindness from eye complications when compared to those without diabetes.

Diabetic Retinopathy can occur in any patient suffering Type 1 or Type 2 diabetes. The longer a patient has had diabetes and the less controlled the blood sugar, then the patient has a higher chance of contracting this disease.

Symptoms

Patients with diabetic retinopathy typically do not experience any symptoms in the beginning. As the condition worsens, the following symptoms might be displayed,

  • Fluctuating vision
  • Eye floaters, the black pots or little threads affecting the vision
  • Blurry or distorted vision
  • Double vision
  • Pain in the eye due to secondary glaucoma
  • Cataracts
  • Total loss of vision

Types of Diabetic Retinopathy

There are two types of Diabetic Retinopathy:

  • Non-Proliferative: is also called Early Diabetic Retinopathy. In this condition, the walls of the retina’s blood vessels weaken and new blood vessels cannot grow. Microaneurysms, or tiny bulges, are found on the walls of smaller blood vessels, leaking fluid and blood into the retina in some cases.

    The nerve fibers of the retina or the macula might swell and this requires immediate treatment.
  • Proliferative: is also called Advanced Diabetic Retinopathy. Here, the damaged blood vessels close off, leading to the growth of new, abnormal blood vessels in the retina. The center of the eye might be filled with a clear, jelly-like substance that could leak from these abnormal blood vessels.

    The retina might get detached from the back of the eye. This usually happened from the scar tissue formed from the growth of new blood vessels. Pressure builds up in the eyeball from the interference of these new blood vessels on the normal flow of fluid out of the eye.

    All these can eventually lead to the damage of the optic nerve, resulting in glaucoma.

Other Diabetic Eye Complications

Another complication of the eye caused by diabetes is Cataract. It is the clouding of the eye lens. The early stages of cataract can be treated with the help of eyeglasses, as the condition progresses surgery is essential to treat cataracts.

There are various methods of surgery mostly involving the removal of the cloudy lens and replacing it with an artificial lens. Patients affected by diabetes are recommended to have a regular eye checkup every 6 months or more, depending on the condition of the eyes.

Diagnosis

Diabetic retinopathy can be diagnosed with the help of the following methods,

  • Heine Indirect Ophthalmoscopy is a diagnostic test done in order to examine the Retina till the periphery of the eye.
  • 90 D slit-Lamp Ophthalmoscopy is a method performed to examine the central retina as well as the macula. 
  • Topcon Digital Fundus Angiography & Color Photography is a procedure carried out to study the blood vessels of the retina and to identify if there are any leaking blood vessels.
  • Fundus Fluorescein Angiography (FFA) is a procedure performed to study the blood vessels that function abnormally or if there is any leakage in the blood vessels. This is done by injecting a fluorescein dye into the vein of the hand followed by taking a series of photographs of the retina of the patient.

Treatment

Once the doctor confirms the diagnosis, various methods of treatment are available for those affected by diabetic retinopathy. These methods include,

  • Iridex green Laser System is used to treat the leaking blood vessels and a damaged retina.
  • Photocoagulation In this procedure, the leaking blood vessels on the retina are sealed by focusing the retina and applying laser spots. This method does not restore lost vision but prevents further loss of vision. 
  • Anti VEGF pharmacotherapy involves injecting anti-VEGF agents such as Avastin or Macugen into the eye through intravitreal injection. This method of treatment is used for treating diabetic maculopathy and proliferative diabetic retinopathy.

Authored By Dr. Lalit Kumar

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