Causes and Diagnosis of Diabetic Retinopathy | Ophthalmology

Diabetic Retinopathy

What is diabetic retinopathy?

Diabetic retinopathy is a complexity of diabetes that influences the eye. It results from damage to the blood vessels of the light-sensitive tissues in the back of the eye (retina). At first, diabetic retinopathy may cause no indications or just gentle vision issues. At last, it can cause blindness.

Anybody with type 1 or type 2 diabetes can build up the condition. The longer you have diabetes and the less control your blood sugar level has, the more likely you are to develop eye complications.

What are the types of diabetic retinopathy?

Nonproliferative diabetic retinopathy (NPDR)

NPDR is also known as background retinopathy. It is called “non-proliferative” because the eye does not make new blood vessels during the early stages of diabetic retinopathy. During the beginning phases of retinopathy, harmed veins regularly spill blood and liquid into the eye. In some cases, the center of the retina, or macula, begins to bulge. This causes a condition called macular edema. The three stages of NPDR are mild, moderate, and severe, which may progress to the other type, or stage IV, which is proliferative diabetic retinopathy.

Proliferative diabetic retinopathy (PDR)

Proliferative diabetic retinopathy, or advanced retinopathy, is a stage of retinopathy in which new blood vessels begin to grow inside the retina. These fresh blood vessels are normally unusual and fill in the focal point of the eye.

Symptoms of diabetic retinopathy

Diabetic retinopathy usually does not show any symptoms during the early stages. The condition is often in an advanced stage when symptoms become noticeable. Sometimes, the only symptom that can be detected is a sudden and complete loss of vision.

Signs and symptoms of diabetic retinopathy may include:

  • Blurred vision
  • Impaired colour vision
  • Floaters, or transparent, colourless spots and dark threads that float in a patient’s field of vision
  • Spots or streaks that obscure the person’s vision
  • Poor night vision
  • Sudden and complete vision loss

DR usually affects both eyes. Ensure that the danger of vision loss is limited. The only way diabetics can prevent DR is by attending every eye examination prescribed by a doctor.

How is diabetic retinopathy caused?

Diabetic retinopathy is caused by high blood glucose levels for long periods of time. Over time, high blood glucose levels can weaken and damage the small blood vessels within the retina.

This may cause bleeding, secretions, and even swelling of the retina. This deprives the retina of oxygen, and the abnormal vessels may grow. Good blood glucose control helps reduce the risk of diabetic retinopathy.

Diagnosis of diabetic retinopathy

Diabetic retinopathy can be determined to have a thorough eye test. It may include testing, focusing on assessment of the retina and macula:

  • Patient history to distinguish vision challenges, the presence of diabetes, and other general wellbeing worries that may influence vision.
  • Visual acuity measurements to determine the extent to which central vision is affected.
  • Refraction to determine if a new prescription for eyeglasses is needed.
  • Evaluation of ophthalmic structures, including evaluation of the retina with a dilated pupil.
  • Measurement of pressure inside the eye.
  • A supplementary test may include:
  • Retinoscopy or tomography to document the current position of the retina.
  • Fluorescein angiography to assess abnormal blood vessel growth.

Risk factors

Anyone who has diabetes can develop diabetic retinopathy. The risk of developing an eye condition could be increased as a result:

  • Duration of Diabetes – The longer you have had diabetes, the greater your risk of developing diabetic retinopathy
  • Poor blood sugar control
  • High blood pressure
  • High in fat
  • Pregnancy
  • Tobacco use
  • Being African American, Hispanic, or Native American

Diabetic retinopathy treatment

Treatments include diabetic retinopathy:

  • Anti-VEGF injection therapy: Medicines that block vascular endothelial growth factor (VEGF), which is a protein that makes abnormal blood vessels grow in your eye, can reverse blood vessel growth and reduce fluid buildup in the retina. Anti-VEGF drugs include Aflibercept (Elijah), bevacizumab (Avastin), and ranibizumab (Lucentis).
  • Focal/grid macular laser surgery: The laser creates small burns on the leaking areas of the vessels in the stain. You may need anti-VEGF treatment after this surgery.
  • Corticosteroids: Doctors can embed or infuse these meds into your eye. There are short-acting and long-acting types. Steroids can increase your chance of developing glaucoma or cataracts. Your eye doctor will monitor the pressure in your eye if you take it.
  • Scatter laser surgery: This treatment causes up to 2000 micro-burns to treat spots where the retina has separated from the macula. This can shrink the abnormal blood vessels. You may need two or more sessions. Laser surgery can save your central vision, but it may reduce side vision, colour, or night vision. It works best if you get it before those new vessels begin to drain.
  • Vitrectomy: If blood vessels leak into the retina and vitreous and withdraw your vision, you may need this procedure. It eliminates the spilt blood so you can see better. This can treat blurry vision.

Your primary care physician will let you know whether any of these medicines are appropriate for you. They will do it in the doctor’s office or the hospital.

Complications

Potential complications associated with diabetic retinopathy include the following:

  • Vitreous hemorrhage: A newly formed blood vessel leaks into the vitreous gel that fills the eye, preventing light from reaching the retina. Symptoms include vision loss and sensitivity to light, or in mild cases, eye floaters. These complications can resolve themselves if the retina remains intact.
  • Detached retina: Scar tissue can pull the retina away from the rear of the eye. This typically brings about drifting spots in a person’s field of vision, blazes of light, and extreme vision misfortune. Retinal detachment represents a high risk of complete vision loss if left untreated.
  • Glaucoma: The normal flow of fluid into the eye may be blocked as new blood vessels form. The blockage causes eye pressure to build up, or pressure, in the eye, which increases the risk of damage to the optic nerve and vision loss.

How is diabetic retinopathy prevented?

If you have diabetes, it is important to maintain the following healthy levels to prevent diabetic retinopathy:

  • Blood pressure
  • Cholesterol
  • Blood sugar

Different approaches to forestall or deal with the condition incorporate the accompanying:

  • Stop smoking if you smoke.
  • Get regular, moderate exercise several times a week. If you have retinopathy, consult your health care team to determine the best exercises for you.
  • Get annual eye exams.
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