Diabetic Retinopathy is the leading cause of new blindness among Americans under the age of 65, but for most patients, having access to early diagnosis and treatment can help prevent vision loss.
What is Diabetic Retinopathy?
Diabetic retinopathy refers to blood vessel damage of the retina caused by complications of diabetes that can lead to significant vision loss and blindness. This condition tends to appear and progress in phases that can be readily observed during routine diabetic eye examinations. These phases include:
- Background Diabetic Retinopathy- The earliest phase of Diabetic Retinopathy is called Background Diabetic Retinopathy. With Type I Diabetes, Background Diabetic Retinopathy does not usually appear until 3-5 years after the initial diagnosis of the disease. With Type II background Diabetic Retinopathy may be observed at the time of the disease. Background Diabetic Retinopathy is characterized by the presence of “dot” and “blotch” hemorrhages and “microaneurysms” in the small blood vessels of the Retina. In many cases, Background Diabetic Retinopathy can occur without causing any disturbance to your vision. In general, Background Diabetic Retinopathy will not require treatment unless it progresses to a phase called Pre-Proliferative Diabetic Retinopathy, which indicates that your vision may be at risk.
- Proliferative Diabetic Retinopathy- If left untreated, Proliferative Diabetic Retinopathy will result in a Vitreous Hemorrhage that can cause scarring and Retinal Detachment with significant loss of vision. Small blood vessels in the retina become weakened and narrow, blocking blood flow. When blood vessels close, they are no longer capable of carrying oxygen to the retinal tissue. In response to the lack of oxygen, the Retina compensates by growing new, but abnormal blood vessels-a process called neovascularization.
What Are the Signs and Symptoms of Diabetic Retinopathy?
Symptoms of diabetic retinopathy may include:
- Floaters and flashers
- Loss of color sensitivity
- General vision blurriness
- Dark areas in the visual field
- Vision loss
Diabetic retinopathy can develop without symptoms. Individuals with diabetes must visit the eye doctor yearly to ensure asymptomatic conditions are diagnosed.
Can You Reverse the Effects of Diabetic Retinopathy?
Early detection and treatment are essential for preventing blindness in individuals with type 1 and type 2 diabetes. Damage done to the eyes by diabetic retinopathy is often permanent. This makes yearly visits to our office for routine screenings all the more important for individuals living with these disorders.
Treatment Options for Diabetic Retinopathy
Depending on the specific problems with your retina, treatment options include:
- Injection of medications into the eye. Medications referred to as vascular endothelial growth factor inhibitors are injected into the vitreous of the eye using a topical anesthesia. They help stop the growth of new blood vessels and decrease fluid buildup. These injections will need to be repeated and in some cases, the medication is used with photocoagulation.
- Photocoagulation is a laser treatment typically done in your doctor's office, that can stop or slow the leakage of blood and fluid in the eye. During the procedure, leaks from abnormal blood vessels are treated with laser burns.
- Panretinal photocoagulation is a laser treatment typically done in-office, that can shrink the abnormal blood vessels. During the procedure, the areas of the retina away from the macula are treated with scattered laser burns. The burns cause the abnormal new blood vessels to shrink and scar.
- Vitrectomy is a procedure that uses a tiny incision in your eye to remove blood from the middle of the eye (vitreous) as well as scar tissue that's tugging on the retina. It's done in a surgery center or hospital using local or general anesthesia.
While treatment can slow or stop the progression of diabetic retinopathy, it's not a cure. Because diabetes is a lifelong condition, future retinal damage and vision loss are still possible. Even after treatment for diabetic retinopathy, you'll need regular eye exams.