Diabetic retinopathy also known as diabetic eye disease, is a medical term used to describe the condition of damage to the retina and eventual blindness (if not treated) as a result of Diabetes Mellitus.
SIGNS & SYMPTOMS OF DIABETIC RETINOPATHY
- In first stage called non-proliferative diabetic retinopathy (NPDR) there are no symptoms.
- Microaneurysms & blocked retinal blood vessels can be detected only through fundus photography & fluorescein angiography.
- Macular edema are formed during NPDR.
- Macular edema occurs when protein deposits collect under the macula of the eye, causing it to thicken & swell.
- Distortion in the central vision of eye in a person can occur.
- Formation of abnormal new blood cells in the second stage called proliferative diabetic retinopathy (PDR).
- Bursting & bleeding of new blood vessels.
- Specks or spots of blood floating in the eye which will go away on their on.
- A following burst of the vessels may occur again which will lead to greater amount of blood draining & present in the eye.
- Blurred vision
- Cotton wool spots.
- Severe bleeding within the eye/Hemorrhage
- Vitreous hemorrhage
- Detachment of the retina
CAUSES & RISK FACTORS
- Diabetes Mellitus: Type I and Type II
- Duration of Diabetes
- High blood pressure
- High blood cholesterol
- Tobacco use.
DIAGNOSIS OF DIABETIC RETINOPATHY
- Visual acuity test for seeing how well a person can see from a distance.
- Ophthalmoscopy: Examination of the retina through a special magnifying glass for a narrow view of the retina.
- Fundus Photography: Photographing the retina of the eye & photo documentation.
- Fluorescein angiography: Utilizes a fluorescein dye which circulates in the vessels of the eye and differentiates any blocked or leaking vessel from the normal ones.
- Retinal vessel analysis detects abnormalities in the retinal vessels & walls of diabetic patients.
- Optical coherence tomography (OCT): An optical imaging modality which produces cross-sectional images of the retina (B-scans) which are used to measure the thickness of the retina.
TREATMENT OF DIABETIC RETINOPATHY
- Intravitreal triamcinolone acetonide: This is a long acting steroid drug that is injected in the vitreous cavity, producing results by a decrease in macular edema & a subsequent increase in the visual acuity.
- Intravitreal anti-VEGF: Good results and an increase in visual quality produced by injecting of anti-VEGF agents like, bevacizumab, aflibercept, ranibizumab.
- Topical NSAIDs.
- Modified grid: A ‘C’ shaped area around the macula is treated with low intensity small burns. This helps in clearing the macular edema.
- Periretinal photocoagulation (PRP): Also called scatter laser treatment, applied to treat proliferative diabetic retinopathy (PDR).
a) Surgical removal of the vitreous humor from the eye.
b) Involving the removal of the cloudy vitreous humor & replacing it with a saline solution.
- Treatment of underlying conditions like hypertension & high blood cholesterol.
- Early detection of damage to the retina by regular screening tests.
- Treatment & management of obstructive sleep apnea.
- Cessation of smoking & tobacco.
- Management of diabetes & blood sugar.