Summary about Disease
Diabetic retinopathy is an eye disease that occurs as a complication of diabetes. It's caused by damage to the blood vessels of the retina, the light-sensitive tissue at the back of the eye. Over time, high blood sugar levels from diabetes can weaken and block these tiny blood vessels, leading to vision loss and potentially blindness if left untreated.
Symptoms
In the early stages, diabetic retinopathy may have no noticeable symptoms. As the condition progresses, symptoms may include:
Blurred or distorted vision
Fluctuating vision
Dark spots or floaters in your vision
Difficulty seeing at night
Color vision impairment
Vision loss
Causes
The primary cause of diabetic retinopathy is prolonged high blood sugar levels associated with diabetes. This elevated glucose damages the blood vessels in the retina. The longer someone has diabetes and the less controlled their blood sugar is, the more likely they are to develop diabetic retinopathy.
Medicine Used
Treatment options and medicines used depend on the stage and severity of the retinopathy. They can include:
Anti-VEGF injections: Medications like Avastin (bevacizumab), Lucentis (ranibizumab), Eylea (aflibercept), and Vabysmo (faricimab) are injected into the eye to block vascular endothelial growth factor (VEGF), a protein that promotes the growth of abnormal blood vessels.
Steroid injections: Injected corticosteroids can help reduce inflammation and swelling in the retina.
Laser surgery:
Focal/Grid laser photocoagulation: Used to seal leaking blood vessels in specific areas of the retina.
Scatter (panretinal) photocoagulation: Used to shrink abnormal blood vessels in more advanced stages.
Vitrectomy: A surgical procedure to remove blood and scar tissue from the vitreous (the gel-like substance that fills the eye).
Is Communicable
Diabetic retinopathy is not communicable. It is not an infectious disease and cannot be spread from person to person. It is a direct result of diabetes and its effect on the blood vessels of the eye.
Precautions
Preventing or slowing the progression of diabetic retinopathy involves:
Blood sugar control: Maintaining stable blood sugar levels through diet, exercise, and medication as prescribed by a doctor.
Blood pressure control: Keeping blood pressure within a healthy range.
Cholesterol control: Managing cholesterol levels.
Regular eye exams: Getting comprehensive dilated eye exams at least once a year (or more frequently if recommended by an eye doctor).
Quitting smoking: Smoking worsens diabetes and increases the risk of eye complications.
How long does an outbreak last?
Diabetic retinopathy isn't an "outbreak" with a defined beginning and end. It is a chronic, progressive disease. Damage accumulates over time with uncontrolled blood sugar. Treatment can halt or slow progression, but the underlying diabetic condition persists. Without treatment, the disease can continue to worsen indefinitely, leading to irreversible vision loss.
How is it diagnosed?
Diabetic retinopathy is diagnosed during a comprehensive dilated eye exam. The doctor will:
Check visual acuity: Using an eye chart to measure how well you see at various distances.
Dilate your pupils: Using eye drops to widen your pupils, allowing a better view of the retina.
Examine the retina: Using a special magnifying lens to inspect the blood vessels, optic nerve, and other structures of the retina.
Fluorescein angiography: A dye is injected into a vein in your arm, and pictures are taken of the retina as the dye travels through the blood vessels. This helps identify leaking or blocked blood vessels.
Optical coherence tomography (OCT): A non-invasive imaging technique that provides cross-sectional images of the retina, helping to detect thickening or swelling.
Timeline of Symptoms
The timeline of symptoms varies greatly from person to person.
Early stages (Nonproliferative Diabetic Retinopathy - NPDR): Often no symptoms. Mild changes in blood vessels might be detectable during an eye exam.
Moderate NPDR: More noticeable changes in blood vessels. Some vision changes may start to occur, but can easily be missed.
Severe NPDR: Significant blood vessel damage. Increased risk of progression to proliferative retinopathy.
Proliferative Diabetic Retinopathy (PDR): New, abnormal blood vessels grow on the retina. These vessels are fragile and prone to bleeding. Symptoms like floaters or blurred vision become more common. Without treatment, severe vision loss or blindness can occur.
Diabetic Macular Edema (DME): Swelling of the macula (the central part of the retina responsible for sharp, central vision). Can occur at any stage of DR. Causes blurred or distorted vision.
Important Considerations
Early detection is crucial: Regular eye exams are vital for people with diabetes, even if they have no symptoms. Early detection and treatment can significantly reduce the risk of vision loss.
Pregnancy and diabetes: Pregnant women with diabetes are at higher risk of developing or worsening diabetic retinopathy. More frequent eye exams are recommended during pregnancy.
Other health conditions: High blood pressure, high cholesterol, and kidney disease can worsen diabetic retinopathy. Managing these conditions is important for eye health.
Patient adherence: Following doctor's recommendations for blood sugar control, medication, and eye exams is essential for managing diabetic retinopathy.
Lifestyle changes: Maintaining a healthy lifestyle, including a balanced diet, regular exercise, and avoiding smoking, can help prevent or slow the progression of diabetic retinopathy.