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Diabetic Retinopathy

What is Diabetic Retinopathy?

Diabetic retinopathy is a complication of diabetes that is caused by the blood vessels of the eye. The retina is a nerve layer at the back of the eye that senses light and helps to send images to your brain.

When blood vessels in the retina are damaged, they may leak fluid or blood (see blue and yellow arrows in diagram), and grow fragile, brush-like branches (yellow arrow) and scar tissue (white arrow). This can blur or distort the images that the retina sends to the brain, and may lead to blindness if left untreated.

Diabetic retinopathy is the leading cause of new blindness among adults in the United States. People with untreated diabetes are said to be 25 times more at risk for blindness than the general population.

If you have diabetes, it's important to know that with today's improved methods of diagnosis and treatment, only a small percentage of people who develop retinopathy have serious vision problems.

Types of Diabetic Retinopathy

Background retinopathy is an early stage of diabetic retinopathy. In this stage, tiny blood vessels within the retina become damaged and leak blood or fluid. Leaking fluid causes the retina to swell or form exudates.
Sometimes the leaking fluid collects in the macula, the part of the retina that lets us see fine details like letters or numbers. This problem is called macula edema. Reading and close work may become more difficult because of this condition.
Proliferative retinopathy describes the changes that occur when new, abnormal blood vessels begin growing on the surface of the retina.

The abnormal growth is called neovascularization. These new blood vessels have weaker walls and may break and bleed into the vitreous cavity. The vitreous is the clear, Jelly-like substance that fills the center of the eye. Leaking blood can cloud the vitreous and partially block the light passing through the pupil towards the retina, causing blurred and distorted images.

The neovascularization can also lead to problems such as severe glaucoma and retinal detachments, which may lead to blindness.

Proliferative diabetic retinopathy is the most serious form of diabetic retinal disease. It affects up to 20 percent of diabetics and can cause severe loss of sight including blindness.

What Are the Symptoms of Diabetic Retinopathy?

Initially, there are usually no symptoms of background retinopathy, although gradual blurring of vision may occur if macular edema is present. As diabetic retinopathy progresses and bleeding occurs, your sight may become hazy, spotty or even disappear altogether. While there is no pain, proliferative retinopathy is a severe form of the disease and requires immediate medical attention. Pregnancy and high blood pressure may aggravate diabetic retinopathy.

How is Diabetic Retinopathy Diagnosed?

The best protection against diabetic retinopathy is to have regular medical eye examinations by your Eye, M.D. Serious retinopathy can be present without any symptoms. The disease can improve with treatment.

To find diabetic retinopathy, your Eye, M.D., looks at the inside of the eye using an instrument called an ophthalmoscope. The pupils may need to be dilated (enlarged) with eye drops.

If your Eye, M.D., finds diabetic retinopathy, he or she may order color photographs of the retina or a special test called a fluorescein angiography to find out if you need treatment. Fluorescein angiography is a test where dye is injected into your arm and special photos of your eye are taken.

How is Diabetic Retinopathy Treated?

Laser surgery by your Eye M.D. is usually effective in the treatment of diabetic retinopathy. A beam of laser light is focused on the damaged retina. Small bursts of the laser's beam seal leaking retinal vessels to reduce macular edema. This is called photocoagulation.

For neovascularization, the laser beam bursts are scattered throughout the side areas of the retina. The small laser scars reduce the abnormal blood vessel growth and protect against further vision loss.

At Kovach Eye Institute, LTD., we perform these laser surgeries in our office. If diabetic retinopathy is detected early, laser surgery slows down vision loss. Even in the more advanced stages of the disease (proliferative retinopathy), it reduces the chance of severe visual impairment.

Vitrectomy

In advanced proliferative diabetic retinopathy, your Eye, M.D., may recommend a vitrectomy. This microsurgical procedure is performed in an outpatient surgical operating room. Vitrectomy removes the blood-filled vitreous and replaces it with a clear solution.

About 70 percent of vitrectomy patients notice an improvement in sight after surgery. Sometimes your Eye, M.D., may wait for a period of time to see if the blood clot clears on its own before going ahead with a vitrectomy.

What is Your Part in Treatment?

Successful care of diabetic retinopathy depends on more than early treatment by your Eye, M.D.

Your attitude and attention to medications and diet are essential. You must maintain normal blood sugar levels, avoid smoking and watch your blood pressure.

In Summary: Vision Loss is Largely Preventable

Retinopathy may be present without any symptoms.
Early detection of diabetic retinopathy is the best protection against loss of vision.
People with diabetes should schedule examinations with their Eye, M.D., once a year.
With careful monitoring, your Eye M.D. can begin treatment before eyesight is affected. Laser and operative surgeries are highly effective treatments for diabetic retinopathy.

If you have questions or would like further information, contact us at (630) 833-9621.

Kovach Eye Institute is dedicated to providing patients with excellence in eye care.

Kovach Eye Institute, LTD., 152 N. Addison Avenue, Elmhurst, Illinois 60126-2748

The Kovach Eye Institute is a part of the DocShop network. DocShop provides free patient education information on diabetic retinopathy.