Treating diabetic retinopathy 

Ophthalmic disorders are one of the complications of long-term uncontrolled diabetes. These include: iris neovascularization, neuropathies, retinopathies, cataracts, corneal complications and glaucoma. Of these, diabetic retinopathy is quite commonly seen in the office of Eye specialist in Islamabad.

Read on to know more about diabetic retinopathy, its symptoms, diagnostics and management options:

What is diabetic retinopathy?

In diabetes, the chronically high blood sugar can damage the innermost layer of blood vessels in the body. When this damage occurs in the blood vessels of the retina, diabetic retinopathy ensues. Consequently, there is swelling, inflammation and leakage from these blood vessels, damaging the sensitive retina and leading to eventual visual loss. In fact, untreated diabetic retinopathy is the leading cause of blindness in the United States, and the commonest ophthalmic disorder in the diabetics, throughout the world. 

What are the types of diabetic retinopathy?

Diabetic retinopathy has two types, and progresses in four stages. The two types of diabetic retinopathy are: non-proliferative and proliferative diabetic retinopathy. The four stages of disease are:

Stage 1: this is the mild non-proliferative stage, which is the earliest form of diabetic retinopathy. It is characterized by areas of tiny swellings in the blood vessels of the retina—known as microaneurysms. At this stage only small amounts of fluid are leaking into the retina. 

Stage 2: moderate non-proliferative stage occurs when the swelling of the blood vessels has increased from the mild form enough to interfere with the blood flow of the retina. Consequently, the retinal layer is deprived of proper nutrition, with macular accumulation of blood and other fluids.   

Stage 3: severe non-proliferative diabetic retinopathy stage is when there is significant blockage of blood flow into the retina. With such blockade, the body releases growth factors to stimulate the growth of new blood vessels on the retina—called neovascularization. 

Stage 4: proliferative diabetic retinopathy is an advanced form of disease whereby new vasculature has already formed on the retina. These new vessels are fragile, and have high risk of fluid and blood leakage, which can trigger loss of vision. 

What are the symptoms of diabetic retinopathy?

The symptoms depend on the stage and type of diabetic retinopathy. In the early stage of disease, the symptoms are mild enough to be ignored. However, later on in diabetic retinopathy, noticeable symptoms are seen, such as:

  • Increased number of floaters in the visual field
  • Blurred vision even with glasses 
  • Dark spots or blank areas in the field of vision 
  • Fading and washing out of colors in the visual field
  • Poor night vision 
  • Difficulty differentiating between colors 
  • Difficulty seeing at night 

These symptoms are bilateral and observed after major damage has already occurred. 

How is diabetic retinopathy diagnosed?

Diagnosis of diabetic retinopathy starts with the examination of retina with a dilated eye. Once the eye is dilated through eye-drops in the doctor’s clinic, fundoscopy is performed to look at the retina. The healthcare provider checks for: blocked blood vessels, swelling of blood vessels, changes in the lens, damage to the nerve tissue, scarring, leaking of vessels and retinal detachment. 

Another possible examination is fluorescein angiography test, in which a dye is injected to trace the tract of blood vessels in the retina. The path of the dye shows blood vessels that are blocked, dilated or broken. 

What are the treatment options?

Treatment of diabetic retinopathy begins with controlling the blood sugar levels, eating right and increasing daily exercise. The progression of disease can slow if diabetes is managed properly. 

Other treatment options include:

Medication: for the inflammatory changes in the eye, steroid injections and eye drops are used, along with anti-VEGF drugs.  

Vitrectomy: is performed for proliferative diabetic retinopathy, to focus light on retina. 

Laser surgery: known as photocoagulation is performed by Best Eye specialist in Lahore, to stop proliferation of blood vessels and decreasing swelling in the vessels. 

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