WHAT IS DIABETIC RETINOPATHY?
Diabetes can affect the eye. Diabetic Retinopathy (DR) is the damage of the retinal vessels in the eye. High blood sugar levels can affect the tiny blood vessels in the eye causing them to leak blood and fluid which may result in bleeding or retinal detachment.
Risk of DR
- Diabetes Mellitus
- Chronic hyperglycemia, hypertension, hypercholesterolemia
Screening for Diabetic Retinopathy
It is important to detect DR early to begin early treatment to prevent permanent visual loss.
Screening should be carried out every 6 months to 1 year. A disc-macula photograph would be taken and dilation may or may not be needed during this screening.
Types of Diabetic Retinopathy
1. Non-proliferative (Background) Diabetic Retinopathy
This is the early stage of DR.
Small blood vessels within the retina leak blood or fluid. Deposits called exudates may form and this leakage of blood may cause bleeding (haemorrhages) on the retina. Swelling of the macula (oedema) may occur affecting the vision which is caused by the fluid leaking from the vessels.
2. Proliferative Diabetic Retinopathy
This is the late stage of DR.
It can affect both the central and side vision. Abnormal growth of new vessels (neovascularization) develop however, these vessels are weak and tend to rupture, causing scarring. Visual loss may be caused by complications like glaucoma, bleeding in the jelly of the eye (vitreous haemorrhage) and retinal detachment.
Optical Coherence Tomography – to scan the different layers of the retina to detect and monitor macular swelling
Fluorescein Angiography – to detect the areas of leakage by having a dye called fluorescein injected into the blood stream.
- Prevention of progression of DR – good control of diabetes, hyperglycemia, systemic hypertension, hypercholesterolemia, living a healthy lifestyle with regular exercise and a balanced diet
- Surgical Treatment
- Intravitreal injections are injections of anti-VEGF or triamcinolone into the vitreous cavity of the eyeball to prevent the growth of these abnormal new blood vessels.
- Argon laser treatment is to seal up and decrease the fluid leakage from retinal blood vessels to reduce swelling of the macula so as to prevent further loss of vision.
-Pan-retinal laser photocoagulation (PRP) prevents new vessels from developing by creating multiple extensive burns at the periphery of the retina to stop any stimulation of the growth of abnormal new blood vessels.
- Vitrectomy to remove vitreous haemorrhage (together with the use of intravitreal anti-VEGF injections)
These treatments may help preserve your remaining vision; however, it will not restore your vision back to normal. Some patient may benefit from low vision aids.