Do you know these 6 features of Diabetic Retinopathy?

Diabetic retinopathy is a serious complication of diabetes mellitus that affects the blood vessels in the retina. It is a complication of diabetes, a disease in which the body's ability to produce or use insulin is impaired. When blood sugar levels are consistently high, it can cause damage to the blood vessels in the body, including those in the retina.

The retina lies in the back portion of the eye which catches light signals and transmits them to the brain via the optic nerve. It is basically a microangiopathy, that is, it affects the smaller blood vessels of a tissue.

Diabetic Retinopathy

It is a leading cause of vision loss among people with diabetes mellitus and can occur in both type 1 and type 2 diseases. Early detection and treatment are important to prevent vision loss and protect your eye health.

In this blog, we will discuss the causes, symptoms, and treatment options for diabetic retinopathy, as well as steps you can take to prevent this condition.

What is Diabetic Retinopathy?

Diabetic retinopathy is a diabetes-related complication that affects the eyes. It occurs when prolonged exposure to high blood sugar levels damages the blood vessels in the retina, the light-sensitive tissue at the back of the eye. The retina plays a crucial role in vision, as it sends signals to the brain through the optic nerve, enabling us to see.

Symptoms:

In its early stages, the mid periphery of the retina is affected due to which retinopathy may not manifest any noticeable symptoms. As the disease progresses and involves the centre of the retina that is the macula, individuals may experience:

1. Blurred or fluctuating vision

2. Floaters, which are dark spots or strings in the field of vision

3. Impaired colour vision

4. Dark or empty areas in the vision

5. Difficulty seeing well at night

It is crucial to note that diabetic retinopathy often affects both eyes.

Risk Factors for Retinopathy:

Several factors contribute to the development and progression of diabetic retinopathy, which include:

1. Duration of diabetes:

The prolonged presence of diabetes significantly amplifies the risk of diabetic retinopathy. The cumulative effect of extended exposure to elevated blood sugar levels heightens the vulnerability of retinal blood vessels to damage and dysfunction.

2. Poorly managed blood sugar levels:

Suboptimal control of blood sugar levels serves as a chief catalyst for diabetic retinopathy. Persistent hyperglycemia induces structural alterations in retinal blood vessels, leading to microvascular complications and compromising the delicate equilibrium essential for ocular health.

3. High blood pressure:

Elevated blood pressure intensifies the mechanical stress on retinal vessels, hastening the degenerative processes that contribute to retinal damage..

4. High cholesterol levels:

Elevated cholesterol levels play a pivotal role in the atherosclerotic changes within retinal blood vessels. This vascular remodelling, triggered by dyslipidaemia, heightens the risk of compromised blood flow to the retina, exacerbating the development of diabetic retinopathy..

5. Pregnancy:

Pregnancy in women with diabetes introduces a unique set of challenges, as the physiological changes associated with gestation intersect with the metabolic issues of diabetes.

6. Genes:

A familial predisposition to diabetes and its complications, including diabetic retinopathy, is a noteworthy risk factor. Genetic factors can influence an individual's susceptibility to the disease and its progression, emphasising the importance of awareness in individuals with a family history of diabetes.

7. Smoking:

Smoking has been identified as an independent risk factor for diabetic retinopathy. The compounds in tobacco smoke contribute to vascular damage, exacerbating the impact of diabetes on retinal blood vessels.

Clinical Presentation:

There are two types of diabetic retinopathy: nonproliferative and proliferative. Nonproliferative diabetic retinopathy is the early stage of the disease and is characterized by swelling and small areas of bleeding in the retina. Proliferative diabetic retinopathy is the more advanced stage and is characterized by the growth of new, abnormal blood vessels in the retina.

Prevention:

Effective management of diabetes is the key to preventing or slowing down the progression of diabetic retinopathy. This involves regular monitoring of blood sugar levels, managing blood pressure and cholesterol levels, adopting a healthy lifestyle, including a balanced diet and regular exercise and annual eye examinations to detect and treat diabetic retinopathy in its early stages.

Treatment:

Several treatment options are available for diabetic retinopathy, depending on the severity of the condition. These may include:

1. Laser therapy:

Laser therapy, known as photocoagulation, is a common treatment for diabetic retinopathy. This procedure involves using a laser to create small burns on the retina. The aim is to seal leaking blood vessels and reduce abnormal vessel growth. Laser treatment can slow the progression of the disease and, in some cases, prevent further vision loss.

The laser may be of two types: Focal/grid laser treatment is specifically targeted at treating diabetic macular oedema. Panretinal photocoagulation, also known as scatter laser treatment, is employed to shrink abnormal blood vessels in the retina. While this approach can reduce the risk of severe vision loss, it may result in some loss of peripheral (side) vision. PRP is often recommended when there is a risk of neovascularization, the formation of new, fragile blood vessels.

2. Intravitreal injections:

Intravitreal injections involve injecting medications directly into the vitreous gel of the eye. Anti-vascular endothelial growth factor (anti-VEGF) drugs/ steroids can be administered to reduce swelling and inhibit the growth of abnormal blood vessels. This approach is particularly effective in managing diabetic macular oedema, a complication of diabetic retinopathy involving fluid accumulation in the macula.

3. Steroid Implants:

In cases of persistent diabetic macular edema, steroid implants may be utilized. These implants release corticosteroids into the eye, reducing inflammation and edema. This option is considered when other treatments, such as anti-VEGF injections, may not be sufficient.

4. Vitrectomy Surgery:

Vitrectomy is a surgical procedure employed in advanced cases of diabetic retinopathy, especially when there is significant bleeding into the vitreous gel. During a vitrectomy, the vitreous gel is removed, and blood is cleared from the eye. This surgical intervention helps improve vision and prevent further complications, such as retinal detachment.

Conclusion:

Diabetic retinopathy is a serious complication that requires careful management and regular monitoring. By maintaining good control of diabetes and adopting a healthy lifestyle, individuals can reduce their risk of developing this sight-threatening condition. Early detection through regular eye examinations is crucial for timely intervention and the preservation of vision. If you have diabetes, prioritise your eye health by working closely with your doctor and scheduling regular eye check-ups.

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