Diabetic Retinopathy

Norma Maddox

Donna

Charlotte

Diabetic Retinopathy

Diabetic retinopathy is a term used for all the abnormalities of the small blood vessels of the retina caused by diabetes, such as weakening of blood vessel walls or leakage from blood vessels.

Diabetic Retinopathy

Diabetic retinopathy is a complication of diabetes that results from damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina).

Diabetic Retinopathy

Diabetic retinopathy affect anyone who has type 1 diabetes or type 2 diabetes. Up to 45 percent of adults diagnosed with diabetes in the United States have some degree of diabetic retinopathy, according to the National Eye Institute. The longer a patient has diabetes, the more likely they are to develop diabetic retinopathy.

Diabetic Retinopathy

Retinopathy progresses from non-proliferative or background retinopathy to proliferative retinopathy.

Diabetic Retinopathy

Non-proliferative retinopathy is a common, usually mild form that generally does not interfere with vision. Abnormalities are limited to the retina and usually will only interfere with vision if it involves the macula. If left untreated it can progress to proliferative retinopathy

Diabetic Retinopathy

Proliferative retinopathy, the more serious form, occurs when new blood vessels branch out or proliferate in and around the retina. It can cause bleeding into the fluid-filled center of the eye or swelling of the retina, and lead to blindness.

Stage 1 of Diabetic Retinopathy

Mild Nonproliferative Retinopathy.

At this earliest stage, microaneurysms occur. They are small areas of balloon-like swelling in the retina's tiny blood vessels.

Stage 2

Moderate Nonproliferative Retinopathy.

As the disease progresses, some blood vessels that nourish the retina are blocked.

Stage 3

Severe Nonproliferative Retinopathy

Many more blood vessels are blocked, depriving several areas of the retina with their blood supply. These areas of the retina send signals to the body to grow new blood vessels for nourishment.

Stage 4

Proliferative Retinopathy.

At this advanced stage, the signals sent by the retina for nourishment trigger the growth of new blood vessels which are abnormal and fragile. They grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye. By themselves, these blood vessels do not cause symptoms or vision loss. However, they have thin, fragile walls. If they leak blood, severe vision loss and even blindness can result.

Functional Implications

As the condition progresses, diabetic retinopathy symptoms may include

– Spots floating in your vision – Blurred vision – Dark streaks or a red film that blocks your vision – Poor night vision – Vision loss – Diabetic retinopathy usually affects both eyes.

Treatment

Treatment for diabetic retinopathy depends on the type of diabetic retinopathy, its severity and how well it may respond to specific treatments.

Early diabetic retinopathy Physician closely monitors

Advanced diabetic retinopathy Requires prompt surgical treatment.

Laser Treatments for Advanced Disease

Focal laser treatment

This laser treatment, known as photocoagulation, can stop the leakage of blood and fluid in the eye. It is done in a doctor's office or eye clinic. During the procedure, leaks from abnormal blood vessels are sealed with laser burns. If vision is blurred from swelling of the central macula before surgery, however, completely normal vision may not occur.

Scatter laser treatment

This laser treatment, also known as panretinal photocoagulation, can shrink the abnormal blood vessels. It is done in a doctor's office or eye clinic. During the procedure, the areas of the retina away from the macula are treated with scattered laser burns. The burns cause the new blood vessels to shrink and disappear. Vision will be blurry for about a day after the procedure. Some loss of peripheral vision or night vision after the procedure is possible.

Laser Treatments for Advanced Disease

Vitrectomy

This procedure can be used to remove blood from the center of the eye and scar tissue that is tugging on the retina. It is done in a hospital under local or general anesthesia. The doctor makes a tiny incision in the eye and blood-filled tissue and scar tissue are removed and replaced with a salt solution, which helps maintain the eye's normal shape. Sometimes a gas bubble must be placed in the cavity of the eye to help reattach the retina. If a gas bubble was placed in the eye, the patient may need to remain in a facedown position until the gas bubble disappears. Often, vitrectomy is followed by laser treatment .

Laser Treatments for Advanced Disease

New Treatments Being Researched

Researchers are studying new treatments for diabetic retinopathy, including medications that may help prevent abnormal blood vessels from forming in the eye. Some of these medications are injected directly into the eye to treat existing swelling or abnormal blood vessels

Prevention Advice for Diabetics

Pay attention to vision changes. Make a commitment to managing diabetes

including diet and exercise Monitor blood sugar level. Keep blood pressure and cholesterol under

control. Do not smoke Take stress seriously

References

http://www.nei.nih.gov/health/diabetic/retinopathy.asp

http://www.nlm.nih.gov/medlineplus/diabeticeyeproblems.html

http://www.mayoclinic.com/health/diabetic-retinopathy/DS00447

http://www.allaboutvision.com/conditions/diabetic.htm

http://www.stlukeseye.com/Conditions/DiabeticRetinopathy.asp