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Diabetic Retinopathy

Definition


Disease: Diabetic Retinopathy Diabetic Retinopathy
Category: Eye diseases

Disease Definition:

Diabetic retinopathy is a diabetes complication resulting from damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina). This condition may initially cause no symptoms or only mild vision problems, but it can eventually result in blindness. Anyone who has type 1 or type 2 diabetes may develop diabetic retinopathy. Additionally, the longer a person has diabetes, the more likely they are to develop diabetic retinopathy. People with diabetes should control their blood sugar level and schedule yearly eye exams in order to protect their vision.
 

Work Group:


Symptoms, Causes

Symptoms:

One can experience retinopathy without being aware of it. Actually, in the beginning, symptoms of diabetic retinopathy might seem strange.
The followings are the symptoms of an advanced stage of diabetic retinopathy:

  • Blurred vision
  • Spots floating in the vision
  • Poor night vision
  • Vision loss
  • Dark streaks or a red film blocking the vision
  • Often both eyes are affected by this condition.
     

Causes:

The body won’t be able to use sugar (glucose) properly when someone has diabetes. As the blood sugar level becomes elevated, the natural lens might swell blurring the patient’s vision. Great amounts of sugar in the blood might finally damage very small blood vessels (capillaries) nourishing the retina, which could eventually lead to diabetic retinopathy. Diabetic retinopathy is often categorized as early or advanced.

 

Early diabetic retinopathy:

The most typical kind of diabetic retinopathy is nonproliferative diabetic retinopathy (NPDR). This condition could be classified into three categories, mild, moderate and severe. In the case of experiencing NPDR, the walls of the blood vessels in the retina weaken. Very small bulges that are known as microaneurysms protrude from the vessel walls, occasionally leaking or oozing fluid and blood into the retina. As this case advances, the tiny vessels might totally close and the larger retinal veins might start dilating and becoming irregular in diameter. The nerve fibers in the retina may start swelling. The central part of the retina (macula) could occasionally start to swell as well, which is referred to as macular edema.

 

Advanced diabetic retinopathy:

The most severe kind of diabetic retinopathy in which abnormal blood vessels develop in the retina is known as proliferative diabetic retinopathy (PDR). The new blood vessels might occasionally develop or leak into the clear, jelly-like substance filling the center of the eye (vitreous). Scar tissue stimulated by the growth of new blood vessels might finally result in the detachment of the retina from the back of the eye. In the case of interference of the new blood vessels with the normal flow of fluid out of the eye, pressure might build up in the eyeball damaging the nerve carrying images from the eye to the brain (optic nerve).
 

Complications

Complications:

Serious vision problems might result from the abnormal growth of new blood vessels in the retina, such as:

 

Vitreous hemorrhage:

When there’s a small quantity of bleeding of the new blood vessels into the clear, jelly-like substance filling the center of the eye, the patient might see only a few dark spots or floaters, but if the bleeding is much more, then blood could fill the vitreous cavity and block the vision altogether. Permanent vision loss might not often result out of vitreous hemorrhage on its own, for the blood usually clears from the eye within a few weeks or months. If the patient’s retina is not damaged, vision might come back to its previous clarity.

 

Retinal detachment:

The retina may be pulled away from the back of the eye in case the abnormal blood vessels that are associated with diabetic retinopathy stimulate the growth of scar tissue. Severe vision loss, spots floating in the vision, and blurred vision may result from this.

 

Glaucoma:

The new blood vessels might intervene with the normal flow of fluid out of the eye and result in pressure in the eye that is able to damage the nerve carrying images from the eye to the brain (optic nerve).

 

Blindness:

Diabetic retinopathy could contribute to complete vision loss.
 

Treatments:

Depending on the kind and severity of diabetic retinopathy someone has and whether it might react to specific treatments or not, treatment for this condition might be determined.

 

EARLY DIABETIC RETINOPATHY:

Treatment might not be necessary straight away in case one has nonproliferative diabetic retinopathy. Yet, the retina would be closely monitored in order to be able to determine whether laser treatment is required or not.

 

ADVANCED DIABETIC RETINOPATHY:

In the case of experiencing proliferative diabetic retinopathy, immediate surgical treatment might be required. Surgery might occasionally be recommended for severe nonproliferative diabetic retinopathy as well. The following treatment options may be available depending on the particular problems with the retina:

 

Focal laser treatment:

This laser treatment, additionally referred to as photocoagulation, performed in the doctor’s office or in an eye clinic, can prevent leakage of blood and fluid in the eye. Laser burns are used to seal leaks from abnormal blood vessels during the operation. Focal laser treatment is often performed in a single session. The patient’s vision will be blurry for about a day after the operation. Tiny spots may occasionally result from laser burns that might be apparent in the visual field. In general, spots fade and go away over time. However, the patient may not recover his/her completely normal vision in case they experienced blurred vision from swelling of the central macula preceding the surgery.

 

Scatter laser treatment:

This laser treatment additionally referred to as panretinal photocoagulation could shrink the abnormal blood vessels. It is performed in the doctor’s office or eye clinic. Scattered laser burns are used in this procedure to treat the areas of the retina away from the macula. The burns cause the new blood vessels to shrink and fade away. Scatter laser treatment is often performed in two or more sessions, and vision will be blurry for about a day after the operation. After the procedure, there might be a risk of losing some peripheral vision or night vision.

 

Vitrectomy:

Eliminating blood and scar tissue from the center of the eye (vitreous) that is tugging on the retina might be performed during this procedure that is done in a surgery center or hospital under local or general anesthesia. A tiny incision is made in the eye during this operation. The blood-filled tissue and scar tissue are removed with delicate instruments and replaced with a salt solution that aids in keeping the eye’s normal shape. A gas bubble should sometimes be positioned in the cavity of the eye to help reattach the retina. Overnight hospitalization might be required after surgery. When a gas bubble is positioned in the eye, the patient may need to stay in a facedown position until the gas bubble fades away, which usually takes a few days or weeks. For a few days or weeks, wearing an eye patch will be required, as well as using medicated eyedrops. Vitrectomy is frequently followed or associated with laser treatment. 

 

The progression of diabetic retinopathy is usually slowed or stopped due to surgery, despite the fact that the condition isn’t curable. Future retinal damage and vision loss is possible since diabetes is a permanent condition. Eye exams on a regular basis might be required even after getting treated for diabetic retinopathy. Additional treatment may also be required at some point.
New treatments are being studied for diabetic retinopathy, such as medications that might aid in keeping abnormal blood vessels from forming in the eye. To treat existing swelling or abnormal blood vessels, some of these medications are injected directly into the eye.
 

Prognosis:

Not available

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