“Diabetic retinopathy involves damage to the retina as a result of the complications of diabetes. Proper monitoring and treatment is crucial in order to control vision loss.”
Dr Devinder Chauhan discusses diabetic retinopathy
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Diabetic retinopathy is a complication of diabetes that damages the blood vessels inside the retina at the back of the eye. It is the result of the effect of high blood sugar levels in the blood vessels (capillaries) in the retina, which can cause them to leak serum or blood, block blood vessels or cause fragile new blood vessels to grow.
It’s a condition that develops slowly and often has no noticeable effect on vision until the condition has become very advanced.
It’s also a very serious, sight-threatening disease that, unfortunately, can develop without affecting vision. This means that it’s critical to have regular checkups at least once a year with your optometrist or ophthalmologist. If retinopathy is detected, you will be referred to a retinal ophthalmologist for further testing and treatment.
Moreover, diabetic retinopathy is the most common cause of blindness in Australian adults under the age of 50.
There are three main types:
Diabetic retinopathy is caused by the effect of high blood sugar levels on the fragile retinal blood vessels. The effect is more prominent over time. However, it’s made even more severe by high blood pressure, high cholesterol levels and smoking.
What all these factors have in common is that they can affect the extent of the damage done to the capillaries (tiny blood vessels), and how easily the blood flows through them. When the retinal blood vessels are compromised, they are unable to deliver oxygen and nutrients to the retinal tissue. As a result, the retina becomes damaged causing blurring and loss of vision. It’s known that controlling diabetes and blood pressure are key factors in preventing sight loss.
Diabetic smokers are at a much higher risk of losing not only vision, but also heart attack, stroke and kidney failure, so it’s critical to stop as soon as possible.
A patient having LASIK laser eye surgery will be in the laser suite for less than 30 minutes.
After dilating the pupils of both eyes, your ophthalmologist will examine the retina. This involves eye drops, which will hold your pupil open so that your ophthalmologist has a clear view of your retina.
Two more tests might also be undertaken to determine the type and treatment that will be most effective – optical coherence tomography (OCT) and fluorescein angiography (FA).
Vision can sometimes be improved by treatment, but stabilising the disease is also a reasonable object of treatment. If the disease is severe, the aim is to slow the progress of the retinopathy.
There are three main methods of treatment: laser, intravitreal injection of either anti-VEGF drugs or steroids; and vitrectomy surgery.
Good diabetes control, maintaining normal blood pressure, ensuring low blood cholesterol and triglycerides are all extremely important measures to be taken to minimise vision risk of developing sight threatening diabetic retinopathy (DR).
Unfortunately, once sight threatening DR has become established, simply controlling the blood sugar will not reverse the ocular problems and specific ocular treatment will be required. Therefore, you should be seen and monitored regularly by your GP, endocrinologist or diabetes nurse educator.
Naturally, your retinal ophthalmologist should be consulted to understand the best way to treat your specific ocular condition.