What is diabetic retinopathy?
We often forget that diabetes is a major threat to our vision. Metabolic problems caused by diabetes can damage the retina. Diabetic retinopathy can cause hemorrhages, retinal vein occlusions, and macular edema (fluid accumulation between retinal layers in the center of vision).
Diabetic retinopathy can seriously affect your vision if it’s not monitored and treated. Without treatment, diabetic retinopathy can cause sudden vision loss leading even to blindness.
Photo: "Normal Retina".
Photo: "Non proliferative diabetic retinopathy and macular edema".
Photo: "Proliferative diabetic retinopathy".
Photo: "Diabetic tractional retinal detachment".
What are the symptoms of diabetic retinopathy?
This disease does not have any symptoms at onset. As the disease progresses, you may notice floaters or vision loss which are signs of a hemorrhage of the retinal veins.
Blurry vision in the center of the field of vision, difficulty reading, faded colors and visual distortion (objects look bent or wavy) can be signs of a macular edema.
Photo: "Vision with diabetic retinopathy".
If I have diabetes, how can I know if I have diabetic retinopathy?
All diabetic patients should have periodic eye exams, with a comprehensive exam of the retina by a specialist. The frequency of these eye exams depends on the damage to the retina and the stage of the disease. A patient with no damage or mínimum damage to the retina can be seen annually, however, if the damage is more severe the patient should be checked more frequently. Sometimes additional tests are needed.
Photo: "Fluorescein Angiography in a Normal Retina"
Photo: "Fluorescein Angiography in a diabetic patient"
Photo: "Normal OCT scan of retina"
Photo: "OCT scan of diabetic macular edema"
Photo: "After vitrectomy and laser treatment of diabetic retinopathy"
What is the treatment for diabetic retinopathy?
The best treatment for diabetic retinopathy is the proper control of diabetes. Blood pressure, cholesterol, and triglyceride levels should also be under control.
If you have proliferative or advanced diabetic retinopathy, it is important to treat it with photocoagulation with laser. This procedure can be done in the doctor’s office and can last between 15 and 30 minutes depending on whether one or both eyes are treated.
In cases of diabetic macular edema (fluid accumulation between retinal layers in the center of vision), intraocular medications are needed and can also be administered in the doctor’s office. These medications help stabilize the patient’s vision and even improve visual acuity.
It is not always possible to treat advanced diabetic retinopathy with laser or intraocular medications. In these cases, the treatment is a surgery called vitrectomy.