Diabetic Retinopathy Treatment
People with prolonged diabetes mellitus are at risk of diabetic eye changes such as retinal microvascular bleeding and leakage. These changes manifest themselves as bleeding spots in the retina and macular swelling. Both diabetic bleeding and macular swelling can be averted by either eye injections or laser surgery depending on the severity.
What Is Diabetic Retinopathy?
This is a complication which affects the retinal tissue in diabetic people. It involves the growth of abnormal blood vessels (neovascularisation) at the back of the eye caused by high blood sugar levels. At the beginning, there may be 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, it can lead to 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.
- Blurred vision
- Empty or dark spots
- Change in colour perception
- Fluctuating vision
- Loss of vision
- Floaters (dark strings drifting in the eyes)
There are different stages. The early proliferative one is when no haemorrhages occur in the vitreous and the growth of abnormal blood vessels is restricted. This stage does not pose a great threat to the patient, although it still bears some risk.
When it comes to the high-proliferative diabetic retinopathy, things are a bit different. The problem spreads to the optic disc and other areas, causing bleeding and disturbed vision (both central and peripheral). This is the more advanced stage, which can cause scar tissue to form in the eye and eventually lead to retinal detachment.
What Are the Risk Factors?
Although retinopathy is mostly found in people diagnosed with diabetes, it is not uncommon for other individuals to have the condition. Here are the most risk factors:
- Type 1 diabetes - those patients are more vulnerable to developing the disease 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;
- Pregnancy - if you have existing retinopathy, pregnancy can speed up eye impairment; expecting mothers who are physically healthy 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 - the disease can be passed down from generation to generation.
Diabetic Retinopathy Treatment
It is always better to receive treatment early rather than late. As mentioned above, advanced diabetic eye disease can result in treacherous retinal detachment
and irreversible vision loss. There are a few options to slow this down.
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 (scatter laser treatment)
This is another 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. The specialist 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. Your condition will improve after a couple of weeks.
The best way to prevent diabetic eye disease 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.
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 retinopathy are oftentimes asymptotic, you may think you have no eye problems. This is why you should never skip a visit to the ophthalmologist and take your condition seriously.
Lastly, it is important to pay attention to symptoms, such as eye floaters which could signify an 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.