Diabetic Retinopathy Treatment – why it is important

What Is Diabetic Retinopathy?

Diabetic retinopathy is a complication that affects the retinal tissue in diabetic people. It involves the growth of abnormal new blood vessels in the retina (neovascularisation) caused by high blood sugar levels. In the beginning, patients with diabetic retinopathy may show no symptoms. What this means is the disease can progress without you even knowing about it unless you examine your eyes on the regular. When the issue gets worse, these high blood sugar levels result in vessels in the retina bleeding, potentially resulting in blindness.

Diabetic retinopathy befalls people with type 1 or 2 diabetes. If it is not treated, it can cause further complications like diabetic macular edema and other vision and retina issues. 

Symptoms of Diabetic Retinopathy include:

• Blurred vision
• Empty or dark spots
• Change in colour perception
• Fluctuating vision
• Vision loss
• Floaters (dark strings drifting in the eyes)

There are different stages of progression of the diabetics eye problem. This is known as proliferative diabetic retinopathy, when someone progresses through diabetic retinopathy stages. It is important to seek treatment for diabetic retinopathy before it progresses. The earlier the treatment, the less change of retina damage due to diabetic retinopathy.

The early proliferative form of diabetic retinopathy is when no hemorrhages occur in the vitreous and the growth of abnormal new blood vessels is restricted. This stage of diabetic retinopathy does not pose a great threat to the patient, although it still bears some risk. At this stage, I generally try to conduct an eye exam to investigate if there is any vision loss, growth of new blood vessels and to observe if there are any abnormal blood vessels.

When it comes to the high-proliferative diabetic retinopathy, things are a bit different. Beyond the new blood vessels and abnormal blood vessels, the problem spreads to the optic disc and other areas, causing bleeding and disturbed vision (both central and peripheral). This is the more advanced retinopathy diabetic stage, which can cause scar tissue to form in the eye and eventually lead to retinal detachment. Vision loss, bleeding from blood vessels and other severe retina issues are to be expected.

What Are the Risk Factors for Diabetic Retinopathy?

Although diabetic retinopathy is mostly found in people diagnosed with diabetes, it is not uncommon for other individuals to have diabetic retinopathy. Here are the biggest risk factors:

• Type 1 diabetes – those patients are more vulnerable to developing the disease in their retina than type 2 diabetes sufferers;
• Kidney impairment – it could lead to vision problems, although in most cases it is retinopathy that causes kidney issues rather than the other way around;
• Poor blood pressure control, leading to blood vessels in the retina being affected;
• Pregnancy – if you have existing retinopathy, pregnancy can speed up eye impairment; expecting mothers who have a healthy retina still risk developing the deformity over time;
• High cholesterol;
• Ill-controlled levels of blood sugar – understandably, diabetics who do not monitor their condition or follow the necessary dietary modifications put themselves at risk for developing retinopathy;
• Gender – it appears that male patients are more likely to suffer from retinopathy than female diabetics;
• Genetic predisposition – a retinopathy diabetic can pass the disposition down from generation to generation.

Diabetic Retinopathy Treatment – What are my options?

It is always better to receive treatment early rather than late. The moment you notice any vision loss, go for a retina eye exam immediately. As mentioned above, advanced diabetic eye disease can result in treacherous retinal detachment and irreversible vision loss. Retina issues can be treated when detected early, either with a laser treatment or eye injection treatment, but once it progresses to the formation of scar tissue in the retina, it gets far more complicated. There are a few options to slow this down.

Diabetes Eye Problem treatment – Anti-vascular endothelial growth factor therapy

It is also called anti-VEGF therapy and the name refers to a protein which participates in the formation of blood vessels. When the latter increases – basically what happens in people with the eye disease in question – it leads to neovascularisation. In general, the treatment involves the use of different drugs to stop this growth. More often than not, they are prescribed to patients suffering from cancer, but they are also proven to work for people with diabetic retinopathy. The medication is administered straight into the eye using an intravitreal injection. The procedure takes no more than half an hour. Before it starts, your eyes will be dilated (widened) with drops, cleaned, and numbed. Then the doctor will attach a small device to keep them open during the session.

The medicine will be injected with a small needle but you will not feel any pain because of the anaesthetic. In the end, the specialist may put antibiotic drops in your eye. As of now, clinical trials are still not able to show exactly how effective this method is and more research is needed. It should be pointed out that the therapy does not help to regain lost vision. What it does is it works to reduce complications. Possible side effects of some drugs include fatigue, diarrhoea, and dermatitis, which happen in different grades.

Panretinal photocoagulation for Diabetic Retinopathy (scatter laser treatment)

This is a laser treatment for diabetic retinopathy that does not promise to restore lost vision, but it can stop the blood vessels from leaking and further aggravating the problem. Hence, it can be used to protect your current level of eyesight. Your ophthalmologist will decide whether you are eligible for the procedure.

It involves the use of a laser which sends tiny bursts of light into the retina that stop leaking. I might have to make 1,500-2,000 small burns into the eye to get the job done. It sounds like a lot, but it is not that scary, besides a local anaesthetic might be applied to ensure that you feel no pain during the intervention. An eyelid holder will be used to keep you from blinking.

It is important to mention that the treatment targets middle and peripheral portions of the eye, whereas the most important parts are left intact (otherwise that would probably result in blindness). The goal of panretinal coagulation is to preserve what is left of the central vision to the detriment of side vision. After the procedure, your eyes will get blurry and it may be difficult to see at night. After the laser treatment, your vision should improve after a couple of weeks.

Diabetes Eyes Retinopathy Prevention

The best way to prevent diabetic eye diseases like diabetic retinopathy is to first control the sugar level well with a good diabetic diet. Your health care provider will give you the rundown on what foods and drinks to avoid. For the most part, you will need to eat plenty of vegetables, beans, whole grains, other types of healthy carbohydrates, and non-fat milk. It is paramount to stay away from dried fruit, sweetened cereals, rice, pasta, white bread, trans fats, maple syrup, honey, and sugar-sweetened beverages, to name a few. These could spike insulin levels and leave you susceptible to diabetes mellitus related conditions such as diabetic retinopathy.

The second step is to ensure yearly eye checks to detect any early diabetic eye changes that can be treated. Because the first stages of diabetic retinopathy are oftentimes asymptotic, you may think you have no eye problems. This is why you should never skip a visit to the ophthalmologist for an eye exam and take your condition seriously.

Lastly, it is important to pay attention to symptoms concerning your vision, such as eye floaters which could signify early eye bleeding, and get treated immediately. Remember that if you are experiencing any eye problems, this could already be a sign that the disease has progressed to the late stage. Take measures as soon as possible to avoid further impairment.