Diabetic Retinopathy - Everything You Should Know
Metabolic Health

Diabetic Retinopathy - Overview

The condition called diabetic retinopathy is caused by high or fluctuating levels of blood glucose caused by diabetes. When a person's blood sugar is too high, they get diabetic retinopathy, which leads to damage to the microcapillaries in their retina. An eye condition called retinal retinopathy affects the retina.

Diabetes patients who do not receive a comprehensive eye examination each year are at risk of losing their vision and even becoming blind. Diabetes can cause blindness, so it is important to seek treatment as soon as possible.

Diabetic Retinopathy Symptoms

There are four stages of diabetic retinopathy, each with different symptoms. The early stages of diabetic retinopathy are challenging to detect since there are no obvious diabetic retinopathy symptoms. There may be bleeding from damaged blood vessels in your retina if you notice floating spots in your field of vision. This phenomenon can sometimes go away on its own. If you are experiencing floaters, impaired vision, or vision loss and one of the underlying disorders that cause retinopathy, you should contact your doctor.

Diabetic Retinopathy Progresses as Follows:

Nonproliferative diabetic retinopathy (NPDR) is a swollen area in the retinal blood vessels that leaks fluid because of a microaneurysm. It is believed that blood vessels nourishing the retina swell as NPDR moderates, negatively affecting blood flow. The retina may appear altered at this stage due to the symptoms of these conditions. You will be able to detect these changes only during a detailed eye examination. Diabetic macular edema, which can cause substantial vision loss, can develop if untreated moderate NPDR is untreated. The mild to moderate forms of NPDR is often called "early" DR. The blood flow to the retina is disturbed, causing more damage to the blood vessels. The retina releases growth factors during this advanced stage of DR, which facilitates the proliferation of blood vessels.

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Risk factors and causes of diabetic retinopathy

Diabetic retinopathy can occur in patients with diabetes, including type 1 and type 2 diabetes and gestational diabetes

A person with diabetes who has had diabetes for a long time is more likely to develop diabetic retinopathy.

Further risk factors for retinopathy include: 

  • High cholesterol levels
  • Hypertension
  • Conceiving
  • Tobacco smoking
  • Native American, Black, or Hispanic

Diabetic Retinopathy Diagnosis

A full eye exam is required for diabetic retinopathy diagnosis. The doctor will dilate your pupils with eye drops during the examination to see inside your eyes more clearly. You might have a fuzzy vision for several hours after using these drops to dilate your pupils. Your eye doctor uses a variety of devices to inspect your eyes and detect any problems. 

  • Bruising of blood vessels
  • Blood or fatty deposits may form in the retina.
  • The inner lining of the retina develops new blood vessels.
  • Scar tissue covers the retina.
  • Bleeding is present in the vitreous fluid.
  • A retinal detachment
  • Optic nerve abnormalities

Your doctor may use fluorescein angiography to take photographs of your retina, which involves injecting a specific dye into your arm. A retinal picture can indicate damaged blood vessels to your doctor. In addition to taking cross-sectional pictures of your retina, your doctor may also use optical coherence tomography. A retina scan can show your doctor how thick your retina is, which can help him or she determine whether fluid has damaged your retina. 

A doctor of optometry can also: 

  • Take a look at your vision
  • Glaucoma should be checked on you.
  • Make sure there are no cataracts present.

Diabetic Retinopathy Treatment

You are more likely to lose your eyesight permanently if you wait too long to treat diabetic retinopathy. NPDR may not require immediate treatment if it is mild or moderate. Still, you should schedule regular eye exams to ensure that your condition is closely monitored.

Surgery will probably be necessary for serious NPDR or PDR diagnoses.

Diabetes is a chronic disease that may result in more damage to the retina and vision loss after surgery. You should keep an eye on your condition by getting routine eye exams.

You should also consult your endocrinologist about strategies for optimizing your diabetes care. When blood sugar levels are well controlled, mild to severe diabetic retinopathy may be halted.

Alternatives Diabetic Retinopathy Treatment to Surgery

Advanced diabetic retinopathy may be treated with the following surgical options:

Substances are injected into the eye

VEGF (Vascular Endothelial Growth Factor) inhibitors help prevent the growth of new blood vessels and improve vision. It is typical for most patients receiving these injections to need them for at least three months. Some people may not require them anymore or less frequently, whereas others will need to continue wearing them to maintain their vision.

Focused laser surgery

The Focused diabetic retinopathy laser treatment seeks to stop or lessen blood flow into the eye by burning and sealing damaged blood vessels.

Photocoagulation is performed in your doctor's office as an outpatient procedure in most cases.

Although your eyesight may not return to normal after the surgery, it should remain stable.

Scatter laser surgery

The scatter diabetic retinopathy laser treatment uses lasers to shrink the damaged blood vessels. This procedure may require several sessions, and your eyesight may be affected for a day or two afterwards.

This treatment may cause you to lose peripheral vision or night vision.

Vitrectomy

A microscopic incision is made in the eye to remove the blood and any scar tissue that could lead to retinal detachment. Anaesthesia is required for this procedure.

Diabetic Retinopathy Can be Prevented by

Following are some tips provided by the Centers for Disease Control and Prevention for keeping your eyes healthy: 

  • You can lower the risk of diabetic retinopathy by following a healthy diet and physically exercising regularly.
  • An annual dilated eye exam is recommended for people with diabetes. A dilated eye exam can detect vision problems early.
  • You should stop smoking or, if you haven't already, don't start. There is a link between smoking cigarettes and diabetes complications like diabetic retinopathy.
  • You should see an eye doctor as soon as you notice any changes in your vision.

Diabetic Retinopathy Complications

  • Haemorrhage of the venous system 
  • Detachment of the retina 
  • Eye disease: Glaucoma

Bottomline

The most challenging aspect of diabetic retinopathy is that it goes unnoticed until advanced. It's also impossible to see the harm it's done to one's eyes unless a doctor notices it during a routine eye exam. Having a healthy lifestyle that includes regular exercise and a balanced diet, obtaining frequent check-ups, and taking medicines or insulin as prescribed by the doctor are some of the procedures you must rigorously adhere to. If you detect any changes in your vision, make an appointment with your eye doctor.

FAQs

Which is the first stage of diabetic retinopathy?

Diabetic retinopathy starts with the walls of the blood vessel in your retina starting to damage. This stage is referred to as mild nonproliferative diabetic retinopathy. During this stage, it is essential to be consistent with the checkups as the symptoms are mild and seem non-existent. At this stage, microaneurysms that are tiny bulges in the blood vessels leak fluid into the retina which leads to swelling of the macula eventually causing diabetic retinography.

What are the 4 stages of diabetic retinopathy?

Diabetic retinography which is one of the severe complications of diabetes mellitus has 4 stages. These stages are mentioned below.

Stage 1: Mild non-proliferative diabetic retinopathy- The stage where there is swelling in the blood vessel of the retina called microaneurysms. It is the early stage of diabetic retinography.

Stage 2: Moderate non-proliferative diabetic retinopathy- At this stage, the swelling in the retina increases restricting proper blood flow to the retina which leads to impoverishment of the retina. 

Stage 3: Severe non-proliferative diabetic retinopathy- At this stage, due to restricted blood flow a section of blood vessels in the retina gets blocked signaling the body to grow new blood vessels.

Stage 4: Proliferative diabetic retinopathy- At this point, the person has reached an advanced stage of the disease and experiences vision problems and even blindness.

Can the diabetic retina be cured?

If you are at a mild to moderate stage of diabetic retinography then consulting the doctor frequently might help you to cure the disease. However, unpaid attention for a long time may lead to a complete loss of eyesight in a person. On the other hand, if you are at a severe non-proliferative retinopathy or proliferative retinopathy stage then surgery is the only treatment that can save you from the disease. Even after surgery chronic diabetes can lead to complications therefore, it is necessary to keep track of the improvement.

Can lowering blood sugar improve vision?

If you are experiencing slight vision problems due to diabetes then managing to control your sugar level can help you to escape from diabetic retinography. With a proper diet and routine exercises, you can easily lower your blood sugar level and improve your vision. However, if the vision problems continue to disrupt your eyesight even after lowering sugar levels then you must consult a doctor and get your eye checked.

What is the test for diabetic retinopathy?

If you want to check whether you are diagnosed with diabetic retinography then you have to go through a dilated eye exam wherein the doctor puts a few drops of liquid into your eye and examines the widened retina to check for any damage caused due to diabetic retinography.

Does laser surgery help diabetic retinopathy?

If you have mild nonproliferative diabetic retinopathy then you may not require laser surgery. However, if you are diagnosed with severe non-proliferative diabetic retinopathy or proliferative diabetic retinopathy then surgery is the main treatment option that can save you from vision loss. There are many surgical methods used to treat diabetic retinopathy like vitrectomy, focused laser surgery, scatter laser surgery, etc. it is essential to consult a specialist who will inform you of the best suitable surgery according to your condition. Although laser surgeries won’t completely treat diabetic retinopathy, it recovers your vision loss to a larger extent. 

How fast does retinopathy progress?

If you have mild nonproliferative diabetic retinopathy then its progression would take several years. However, if you are diagnosed with severe non-proliferative diabetic retinopathy then it can progress to proliferative diabetic retinopathy within a year and this situation can cause severe damage to your eyesight. The progression rate of diabetic retinopathy depends on many factors like your blood sugar levels, cataract surgery, etc.

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