Diabetic Retinopathy

Diabetes mellitus is a chronic disease characterized by inability to utilize the sugars (carbohydrates) in our diet. It is caused by insufficient production of insulin by the pancreas. Uncontrolled diabetes frequently affects the eyes and can cause cataracts, glaucoma, optic nerve problems and most significantly damage to the blood vessels of the retina which results in diabetic retinopathy. Diabetes can affect adults and children as well. 

Diabetic retinopathy is a complication of diabetes mellitus that affects the inner part of the eye called the retina. The retina is the innermost lining of the eye and is responsible for receiving visual images for transmission to the brain. 

Diabetes causes changes in the blood vessels of the retina that leak fluid and/or blood. The smaller blood vessels called capillaries become narrowed and/or obstructed while others form balloon-like sacs. These changes cause the vessels to leak blood and fluid, seen as hemorrhages, exudates and/or swelling. 

Diabetic retinopathy is also one of the leading causes of blindness, especially if undetected or left untreated. 

The risk of developing diabetic retinopathy increases the longer the patient has diabetes and the poorer the sugar control is.

Treatment depends on the stage of the retinopathy. If the retinopathy is still in the early nonproliferative diabetic retinopathy stage, repeated eye checks are recommended.

If the diabetic retinopathy is progressing, retinal photos and a fluorescein angiography (FA) may be requested to document the stage of the disease. This exam involves injecting a dye into the arm vein and taking photos of the retina to see which vessels are leaking or which areas lack adequate blood supply. Moreover, an FA may help decide if laser treatment for the retinopathy is needed and how soon the laser treatment should be started.

At the appropriate stage, PRP or pan-retinal photocoagulation (laser of the retina) is performed to prevent the blood vessels from growing continuously, thereby preventing bleeding. Most significantly, appropriate timing of PRP can prevent blindness. If you are diagnosed as having diabetic macular edema, laser therapy of the macular portion or intraocular injections of medications may be recommended.

If cataracts are present, a cataract operation may be recommended.

If blood is noted in the vitreous or in more advanced cases where scar tissue has caused the retina to detach, a surgical procedure called pars plana vitrectomy may be recommended to repair the condition.

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