DIABETIC RETINOPATHY
DIABETIC RETINOPATHY
Diabetic retinopathy is a complication that affects the eyes and can develop in anyone who has type 1 or type 2 diabetes. It’s caused by damage to the blood vessels of the retina.
Dr. Neeraj Sanduja, the best retina specialist in Gurgaon says that in its early stages, diabetic retinopathy usually causes no symptoms. As the disease progresses, one might develop:
- Spots or dark strings floating in the vision (floaters)
- Blurred vision
- Fluctuating vision
- Dark or empty areas in the vision
- Vision loss
In later stages, it can even lead to blindness. Thus regular dilated retina evaluations by a retina specialist in diabetic patients can pick up the disease in its early stages and prevent severe vision loss.
The longer one has diabetes and the less controlled one’s blood sugar is, the more likely is he/she to develop diabetic retinopathy.
Risk factors
Anyone who has diabetes can develop diabetic retinopathy. The risk of developing the eye condition can increase as a result of:
- Having diabetes for a long time
- Poor control of blood sugar level
- High blood pressure
- High cholesterol
- Pregnancy
- Tobacco use
- Anaemia, compromised renal status
There are two types of diabetic retinopathy:
- Early diabetic retinopathy. In this more common form — called nonproliferative diabetic retinopathy (NPDR) — new blood vessels aren’t growing (proliferating).
In nonproliferative diabetic retinopathy (NPDR), a retina specialist sees that the walls of the blood vessels in the retina weaken causing leakage of fluid and blood into the retina.
NPDR can progress from mild to severe as more blood vessels become blocked.
Sometimes retinal blood vessel damage leads to a buildup of fluid (oedema) in the centre portion (macula) of the retina. If macular oedema decreases vision, treatment in the form of intravitreal injections/ laser by a retina specialist is required to prevent permanent vision loss.
- Advanced diabetic retinopathy. Diabetic retinopathy can progress to this more severe type, known as proliferative diabetic retinopathy (PDR). In this type, damaged blood vessels close off, causing the growth of new, abnormal blood vessels in the retina. These new blood vessels are fragile and can leak into the clear, jellylike substance that fills the centre of the eye (vitreous). (Vitreous Haemorrhage) In this case, immediate attention is needed and it is recommended that you visit the best retina specialist in Gurgaon
PROLIFERATIVE DIABETIC RETINOPATHY (PDR)
PDR WITH VITREOUS HAEMORRHAGE
Eventually, scar tissue from the growth of new blood vessels can cause the retina to detach from the back of the eye. (Tractional Retinal Detachment)
PDR WITH TRACTIONAL RETINAL DETACHMENT
If the new blood vessels interfere with the normal flow of fluid out of the eye, pressure can build in the eyeball. This build-up can damage the nerve that carries images from the eye to the brain (optic nerve), resulting in glaucoma. (Neovascular Glaucoma)
Prevention
Regular eye exams by a retina specialist, good control of blood sugar and blood pressure, and early intervention by the best retina specialist in Gurgaon for vision problems can help prevent severe vision loss.
- Regular monitoring and good control of blood sugar levels.
- Ask your retina specialist about a glycosylated haemoglobin test. The glycosylated haemoglobin test, or haemoglobin A1C test, reflects the average blood sugar level for the two- to three-month period before the test. For most people with diabetes, the A1C goal is to be under 7%.
- Keeping blood pressure and cholesterol under control.
- Avoid smoking/ or use of other types of tobacco
- Pay attention to vision changes
TREATMENT
- Injections: anti-VEGFs/ steroid:
These medications when injected in the back of the eye by a retina specialist, help reduce swelling of the macula, slowing vision loss and perhaps improving vision. Multiple such injections are needed depending on the severity of one’s Diabetic Retinopathy and control.
- Laser Treatment
Laser is used to help seal off leaking blood vessels (FOCAL LASER). This can reduce swelling of the retina.
The laser can also help shrink blood vessels (PANRETINAL PHOTOCOAGULATION/ PRP LASER) and prevent them from growing again. This is done in multiple sittings. Sometimes more than one treatment is needed as recommended by the retina specialist
LASERED DIABETIC RETINA (AFTER PRP LASER)
- Vitrectomy
With advanced PDR, (Vitreous Haemorrhage or Tractional Retinal Detachment), surgery called vitrectomy (Pars Plana Vitrectomy/ MicroIncision Vitrectomy Surgery) is needed.