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Diabetes Retinopathy

Q: What is it?

A: Diabetic retinopathy is a complication of diabetes mellitus which causes abnormalities in the blood vessels of the retina. These damaged blood vessels may leak fluid or blood, and fail to provide nutrients necessary for good health in the retina. Left untreated, diabetic retinopathy can result in severe visual loss, including blindness. The risk of developing diabetic retinopathy increases the longer a person is a diabetic.

About 80% of the people with at least a 15 year history of diabetes have some blood vessel damage to their retina. Diabetic retinopathy is particularly likely to occur at a younger age in juvenile diabetics, who have been diagnosed with the condition during their childhood or teenage years.


Q: Are there different types?

A: Background Retinopathy is an early stage of diabetic retinopathy. In this stage, fine blood vessels within the retina become narrowed or obstructed while others enlarge. Sight is usually not seriously affected. It can, however, lead to more advanced sight-threatening stages.

Macular Edema is caused by leaking fluids collecting in the macula. Reading and close work may become more difficult because of this condition.

Proliferation Retinopathy describes the change that occurs when new, abnormal blood vessels begin growing on the surface of the retina or the optic nerve. These new blood vessels have weaker walls and may rupture and bleed into the vitreous. This leaking blood can cloud the vitreous and partially block the light passing through the pupil towards the retina, causing blurred and distorted vision. These abnormal blood vessels may pull the retina away from its normal position at the back of the eye causing a detached retina. Abnormal blood vessels may also grow around the pupil causing glaucoma.


Q: Can children get it?
A:
Yes.


Q: Is aging a factor?
A:
Yes.


Q: What causes it?

A: The cause of diabetic retinopathy is not completely understood. However, it is known the diabetes damages small blood vessels in various areas of the body. Pregnancy and high blood pressure may aggravate diabetic retinopathy.

Q: What are the signs or symptoms?

A: Though vision may gradually become blurred, significant loss of sight does not usually occur with background retinopathy. Since the patient does not experience pain or external symptoms such as bloodshot eyes or discharge, changes in the retina can go unnoticed unless detected by an eye examination.

When bleeding occurs in proliferative retinopathy, the patient has clouding or complete loss of vision. Connective tissue pulling on the retina causes distortion and blurring. However, if abnormalities occur in the peripheral retina, the patient may not experience any symptoms.

A comprehensive eye examination and appropriate treatment by an ophthalmologist is the best protection against eye damage due to diabetic retinopathy. Serious retinopathy can be present without symptoms, which can improve with treatment. To detect diabetic retinopathy, a painless examination of the inner eye is conducted using an ophthalmoscope. If diabetic retinopathy is detected, a fluorescein angiography, the taking of rapid photographs as dye passes through the retinal blood vessels, is often used to determine what or even if further treatment is necessary.


Q: Can it be prevented?

A: Unfortunately, no. Diabetic retinopathy is a complication of a disease which can strike anyone. Even the most careful diabetic has a 50-50 chance of developing retinopathy, particularly if they have had the disease for 15 years or more.


Q: How is it treated?

A: Treatment of diabetic retinopathy depends on the location of the disease and the degree of damage to the retina. If retinopathy occurs in the peripheral retina, careful monitoring of the disease may be all that is necessary. When the macula and central vision is affected, laser treatment is usually necessary.

In cases of background diabetic retinopathy, lasers may be used to seal blood vessels that have leaked. Laser treatment may not halt the disease entirely, but can reduce further vision loss by delaying the onset of proliferative retinopathy.

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