Diabetic retinopathy

Diabetic retinopathy: Symptoms, Treatment & medicines

Diabetic retinopathy is the most common cause of vision loss among people with diabetes and can occur in anyone who has the disease, regardless of whether they have type 1 or type 2 diabetes. In the early stages of diabetic retinopathy, the blood vessels may leak fluid or small amounts of blood, which can cause swelling and distortion of the retina. This can lead to blurred vision or difficulty seeing in dim light.

Everything You should know

Symptoms of Diabetic Retinopathy

In the early stages of diabetic retinopathy, there may be no noticeable symptoms, which is why regular eye exams are crucial for detecting and treating the condition before it progresses. However, as diabetic retinopathy worsens, the following symptoms may occur:

Blurred vision: This is a common symptom of diabetic retinopathy. It can occur when the blood vessels in the retina leak fluid or blood, which can cause the retina to swell and affect vision.
Floaters: Small specks or spots that appear to float in the field of vision are called floaters. They can be a symptom of diabetic retinopathy and occur when the blood vessels in the retina bleed.
Fluctuating vision: Some people with diabetic retinopathy experience vision that fluctuates, meaning it changes from clear to blurry and back again. This can happen when the blood sugar levels are not well-controlled.
Blind spots: Blind spots can occur when parts of the retina are damaged or die due to lack of
blood supply. These blind spots can affect a person’s ability to see clearly.
Impaired color vision: People with diabetic retinopathy may have difficulty distinguishing colors or seeing colors as vividly as they used to.
Dark or empty areas in vision: This is a less common symptom of diabetic retinopathy, but it can occur when blood vessels in the retina become blocked, causing areas of the vision to go dark or empty

Causes of Diabetic Retinopathy

Diabetic retinopathy is caused by damage to the blood vessels in the retina of the eye, which is a complication of diabetes. High blood sugar levels can cause the blood vessels in the retina to become weakened and damaged over time. Some specific causes of diabetic retinopathy include:

Poor blood sugar control: If a person with diabetes does not manage their blood sugar levels well, it can lead to damage to the blood vessels in the retina.
High blood pressure: People with diabetes who also have high blood pressure are more likely to develop diabetic retinopathy.
High cholesterol: High levels of cholesterol in the blood can also increase the risk of developing diabetic retinopathy.
Duration of diabetes: The longer a person has diabetes, the higher their risk of developing diabetic retinopathy.
Genetics: Some people may have a genetic predisposition to developing diabetic retinopathy.
Smoking: Smoking can increase the risk of developing diabetic retinopathy, as it can damage blood vessels and reduce blood flow.

four stages of diabetic retinopathy

There are four stages of diabetic retinopathy, which are classified based on the severity of the condition:

Mild nonproliferative diabetic retinopathy: In this stage, small areas of swelling called microaneurysms occur in the blood vessels of the retina. These may not cause any symptoms and may only be detected during an eye exam.
Moderate nonproliferative diabetic retinopathy: As the condition progresses, the blood vessels in the retina may become blocked, preventing blood from reaching some areas of the retina. This can cause the retina to become ischemic, or deprived of oxygen. In response, the retina may grow new blood vessels, but these are weak and can leak fluid, leading to swelling in the retina.
Severe nonproliferative diabetic retinopathy: In this stage, more blood vessels become blocked, and there is a significant risk of vision loss. The growth of new blood vessels in the retina increases, and they may be larger and more numerous than in the previous stage.
Proliferative diabetic retinopathy: It is the most advanced stage of diabetic retinopathy, which is caused by new blood vessels growing on the surface of the retina and into the vitreous, causing floaters or vision loss. Scar tissue can form, which can pull on the retina and cause it to detach, leading to severe vision loss or blindness.

how to diagnose Diabetic Retinopathy?

Diagnosing Diabetic Retinopathy typically involves a comprehensive eye examination by an ophthalmologist or optometrist. The eye doctor will look for signs of damage to the blood vessels in the retina, changes in the shape or thickness of the lens, and changes in the pressure inside the eye. Here are the steps typically involved in diagnosing Diabetic Retinopathy:

Dilated eye exam: A dilated eye exam is the most effective way to detect diabetic eye disease. During this exam, eye drops are used to widen the pupils, allowing the eye doctor to see the inside of the eye more clearly.
Visual acuity test: A visual acuity test measures how well you can see at a distance. This test involves reading letters or numbers from an eye chart.
Tonometry: Tonometry is a medical diagnostic technique used to measure the intraocular pressure (IOP) inside the eye, which is important for diagnosing and managing conditions such as glaucoma. There are different techniques for tonometry, including applanation tonometry, non-contact tonometry, and tonometry with a handheld device. Tonometry is a safe and painless procedure that can be performed in an ophthalmologist’s office or clinic.
Optical coherence tomography (OCT): Optical coherence tomography (OCT) is a non-invasive medical imaging technique that uses light waves to create high-resolution images of the structures inside the eye, such as the retina, optic nerve, and macula. OCT is commonly used in the diagnosis and management of various eye conditions and is a safe and painless procedure that can be performed in an ophthalmologist’s office or clinic. The images produced by OCT are highly detailed and can provide valuable information about the health of the eye.

What is the best treatment for diabetic retinopathy?

The best treatment for diabetic retinopathy depends on the severity of the condition and the individual case. Here are some common treatment options for diabetic retinopathy:

Managing blood sugar levels: Keeping blood sugar levels under control is essential in managing diabetic retinopathy. This can be done through diet, exercise, and medications prescribed by a doctor.
Laser surgery: Laser surgery is a common treatment for diabetic retinopathy. It works by sealing leaking blood vessels and reducing the growth of abnormal blood vessels. It can also help reduce swelling in the retina.
Vitrectomy surgery: In advanced cases of diabetic retinopathy where there is severe bleeding or scarring, vitrectomy surgery may be necessary. This surgery involves removing the vitreous gel and scar tissue from the eye.
Anti-VEGF injections: These are injections of medication into the eye that help to reduce the growth of abnormal blood vessels and can help reduce swelling in the retina.
Steroid injections: These injections may be used to reduce inflammation in the eye, which can help improve vision in some cases.

It’s important to note that treatment for diabetic retinopathy is not a cure, and it cannot reverse the damage that has already occurred. However, early detection and treatment can help slow or stop the progression of the condition and prevent further damage. Regular eye exams are essential in detecting and managing diabetic retinopathy.

Prevention of Diabetic Retinopathy

Prevention of diabetic retinopathy involves managing diabetes and controlling blood sugar levels, blood pressure, and cholesterol levels. Here are some specific steps that can help prevent diabetic retinopathy:

Control blood sugar levels: Keeping blood sugar levels under control is crucial in preventing diabetic retinopathy. This can be done through diet, exercise, and medications prescribed by a doctor.
Manage blood pressure: High blood pressure can damage blood vessels in the eye, so it’s essential to manage blood pressure through a healthy diet, exercise, and medications prescribed by a doctor.
Manage cholesterol levels: High cholesterol levels can also contribute to the development of diabetic retinopathy, so it’s important to manage cholesterol levels through a healthy diet and medications prescribed by a doctor.
Quit smoking: Smoking can increase the risk of developing diabetic retinopathy, so quitting smoking is an important step in preventing the condition.
Regular eye exams: Regular eye exams are essential in detecting and managing diabetic retinopathy.

By managing diabetes and controlling blood sugar, blood pressure, and cholesterol levels, and by quitting smoking and having regular eye exams, people with diabetes can help prevent the development of diabetic retinopathy or catch it early when it’s most treatable.

Medicines For Diabetic Retinopathy

There are different types of medicines used for diabetic retinopathy, and the choice of medication depends on the severity of the condition and individual factors. Here are some of the most commonly used medications for diabetic retinopathy:

Anti-VEGF drugs: These drugs work by blocking the action of a protein called vascular endothelial growth factor (VEGF), which promotes the growth of abnormal blood vessels in the retina. By blocking the action of VEGF, these drugs can help reduce the growth of new blood vessels and prevent leakage from existing blood vessels. Commonly used anti-VEGF drugs include ranibizumab, aflibercept, and bevacizumab.
Steroids: Steroid medications can be injected into the eye to help reduce inflammation and swelling, which can improve vision in some cases. Commonly used steroids for diabetic retinopathy include triamcinolone and dexamethasone.
Laser therapy: Although not a medication, laser therapy is often used to treat diabetic retinopathy. It works by creating tiny burns on the retina to seal leaking blood vessels and reduce the growth of new blood vessels.
Aspirin: While not specifically used to treat diabetic retinopathy, some studies suggest that taking low-dose aspirin may help reduce the risk of developing the condition.