Diabetic retinopathy
People with diabetes can develop an eye disease called diabetic retinopathy. High blood glucose (sugar) levels cause damage to blood vessels in the retina. Blood vessels damaged during diabetes become swollen. As a result, blood flow in the blood vessels is disrupted and the retina is damaged. Over time, new, abnormal blood vessels appear in the retina, which often causes hemorrhage inside the eye and a dramatic deterioration in visual acuity.
There are two main types of diabetic retinopathy
Nonproliferative diabetic retinopathy is mostly found in the early stages of the disease. At this time, increased seepage from small blood vessels causes retinal edema. Clinically significant is the edema of the central part of the retina, the macula, which sharply worsens visual acuity. Impaired blood flow in the retinal vessels leads to oxygen depletion of the retina. This process is called ischemia. Chronic ischemia reduces visual function, and numerous small hemorrhages appear within the retina.
Proliferative diabetic retinopathy is a more severe manifestation of the disease. In the proliferative phase, new, abnormal blood vessels appear. The new blood vessels are easily damaged, causing hemorrhages inside the eye. Over time, pathological tissue appears on the surface of the retina, which is tightly connected to the retina and exerts mechanical influence on it. As a result, a retinal detachment develops, which is called a tractional retinal detachment. Tractional retinal detachment dramatically worsens vision and can lead to complete blindness.
Diabetic retinopathy is often asymptomatic in its early stages, although as it progresses, the following symptoms may occur:
- Deterioration of vision
- The appearance of many “floating” spots and specks in the field of vision.
- Decreased ability to perceive colors
- Decreased night vision
- Sudden loss of vision
Diabetic retinopathy usually affects both eyes.
Diagnosis
Diabetic retinopathy initially begins asymptomatic, although signs of retinopathy may be detected early in an ophthalmologic examination. Therefore, it is important for patients with diabetes to periodically undergo a thorough ophthalmologic examination. The purpose of the examination is to start treatment in time when early signs are detected to prevent further development of the disease.
This examination includes the following:
- Visometry - checking visual acuity
- Tonometry - measurement of intraocular pressure
- Examination of the anterior part of the eye with a slit lamp.
- Funduscopy - examination of the retina with a special microscope.
- Fluorescence angiography - assessment of the degree of vascular damage (seapage) using a special contrast
- Optical coherence tomography (OCT), which allows for layer-by-layer analysis of the retina.
Treatment
Treatment of diabetic retinopathy depends on its severity. In the early stages of the disease, the ophthalmologist can only monitor the patient’s condition. At this time it is important for the patient to monitor blood glucose (sugar) levels and blood pressure.
As the disease progresses, panretinal laser photocoagulation and/or intravitreal (intraocular) injection of a drug may be required which helps reduce the appearance of new blood vessels in the retina (neovascularization) and their edema.
In the advanced stage of the disease, patients often need a surgical intervention - vitrectomy. Vitrectomy removes the transparent tissue of the eye and the vitreous body in addition to the hemorrhage. New, scar tissue (membrane) is removed from the surface of the retina and the wrinkled retina is straightened. The damaged areas are treated by laser. If the retina detaches, it returns to its place.
Summary
Diabetic retinopathy is a serious eye disease that can potentially lead to blindness. Observation by an ophthalmologist and early treatment significantly reduces the likelihood of complications associated with the disease.
The National Center of Ophthalmology is open 24 hours a day. The Center continues to see patients around the clock for both routine and emergency cases. Contact us: 032 2 190 190 190.
