Diabetic Retinopathy is a condition caused by diabetes complications that refers to damaged blood vessels inside the eye retina. These vessels leak fluid into the retina and the macula, and often cause the region to swell and actually bulge out, resulting in blurred vision.
Up to 80% of all patients who have had diabetes for 10 years or more will experience some form of diabetic retinopathy. If left untreated, this ailment can lead to blindness. Fortunately, new cases can be helped through mindful treatment and regular monitoring.
Risk Factors of Diabetic Retinopathy
- Suffering from Type I or Type II diabetes for 10+ years
- High blood pressure
- Frequent high blood sugar levels
- High cholesterol
Diabetic Retinopathy Stages
Diabetic retinopathy does not offer any real warning signs, as there are no symptoms experienced in the first stage of the disease – patients may even have 20/20 vision at this time. Yet in some cases, the vessels have already started to bleed, while leakage into the retina and macula can happen in any and all stages of diabetic retinopathy. The condition can only be detected early on by an eye photo, known as fundus photography; a procedure which shows microscopic blood-filled bulges in the artery walls. For those with reduced vision, fluorescein angiography can be used to take a picture of the back of the patient’s eye.
In its second stage, abnormal new blood vessels will begin to form at the back of the eye, and can burst and bleed. This is when vision becomes blurred. Patients may also see spots floating in their visual field; however these will typically disappear after a few hours. After a few weeks, vision will be further destructed by a greater amount of blood leakage. These hemorrhages will increase with time and happen most often while the patient is sleeping.
In the third and final stage of diabetic retinopathy – sometimes referred to as proliferative diabetic retinopathy – the damaged blood vessels begin to grow along the retina due to a lack of oxygen. This will distort the patient’s vision so that items appear wavy, and straight lines look crooked or bent. Without treatment, these new blood vessels will bleed and eventually destroy the retina.
Treatments for Diabetic Retinopathy
Although there is no absolute cure, three highly effective treatments do exist for reducing vision loss in advanced cases of diabetic retinopathy.
Focal Laser Surgery
In the treatment of advanced cases, laser surgery is used to burn the abnormal blood vessels that form in the retina, in order to stop or slow the leakage or blood or fluid into the eye. Laser surgery has been shown to reduce the risk of severe vision loss by 50%. However, caution should be taken with laser surgery since it causes a loss of retinal tissue.
PRP, also called scatter laser treatment, is a more aggressive laser surgery that aims to burn between 1,200 to 1,800 individual laser spots over multiple sessions. The ophthalmologist numbs the eye with anesthetic and holds a special lens on the eye, using a single spot laser or pattern scan laser to burn the retina. This will, hopefully, reduce the retina’s oxygen demand and save the center of the patient’s sight, although some peripheral vision may be lost.
In cases where there is too much blood leakage in the center of the eye, a vitrectomy surgery might be used. Vitrectomy is also done under local anesthesia. The surgeon makes an incision into the sclera, which is the white of the eye. Next, an instrument is used to drain the vitreous and replace it with saline solution. Patients who have this surgery may be asked to stay overnight in the hospital. For follow-up, patients will need to wear an eye patch for a few days or weeks to protect the eye.
Patients suffering diabetic retinopathy will medical monitoring and ongoing treatments to maintain their vision. However, with any of these three treatments, people with advanced diabetic retinopathy have a 90% chance of retaining their vision, should they begin treatment before serious damage to the retina occurs.
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