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Diabetic Retinopathy
Diabetic retinopathy is the most common eye affliction resulting from
diabetes. In the worst cases, it can result in complete vision loss. Both
diabetes 1 and 2 can lead to diabetic retinopathy, which affects almost
50% of diabetics. In the United States, diabetic retinopathy is the
leading cause of blindness. Early detection and treatment are critical to
minimize the risk of profound vision loss in diabetics, and with proper
treatment, the risk of complete vision loss is low.
What is Diabetic Retinopathy?
Diabetic retinopathy is caused by high blood sugar levels. High blood
sugar affects many parts of the body, including the capillaries that bring
nourishment to the retina. The retina is responsible for transferring
visual images to the brain.
Diabetic retinopathy occurs in two forms, and usually affects both eyes.
1) Nonproliferative diabetic retinopathy (NPDR)
Also referred to as background diabetic retinopathy, this is the most
common and early stage of this eye disease. Symptoms are often minimal,
and even nonexistent. In nonproliferative diabetic retinopathy, very small
bulges form in the weakened capillaries of the retina. These bulges,
called microaneurysms, can leak fluid and blood into the retina. As well,
bunches of swollen nerve fibers can appear. The end result can be either
swelling of the macula, the central part of the retina, or a reduction of
blood flow to the macula. This interference with the proper functioning of
the macula can result in a loss of central vision.
2) Proliferative diabetic retinopathy (PDR)
PDR is an advanced form of diabetic retinopathy and is diagnosed when
abnormal growth of blood vessels in the optic nerve or retina is present.
The growth of these blood vessels results from the actual closing of
capillaries in the retina and can result in decreased central and
peripheral vision. The closing of capillaries results from high blood
sugar levels in the body, and can result in several complications,
including leaking blood vessels,
retinal detachment, and the development
of neovascular glaucoma.
Many diabetics commonly experience blurred vision. Rapid changes in blood
sugar levels can lead to the accumulation of blood sugar byproducts in the
lens. This causes the lens to swell and makes distant objects appear
blurred or fuzzy (nearsightedness). Macular swelling can also occur and
cause the capillaries to hemorrhage. This causes spots to appear in the
visual field.
Are you at risk?
Both type 1 and type 2 diabetes puts a patient at risk for diabetic
retinopathy. The risk increases the longer a patient has diabetes.
Diabetics can minimize their risks by ensuring that blood sugar levels are
properly controlled, by controlling high blood pressure and blood
cholesterol, and by controlling body weight. Pregnancy and kidney disease
also put a patient at increased risk.
Diagnosing Diabetic Retinopathy
Diabetics should undergo a comprehensive
eye exam at least once a year. A
doctor will look for any of the following signs of diabetic retinopathy.
- Swelling of the retina
- Hemorrhage in the retina
- Leaking capillaries
- Retinal fatty deposits
- Closure in capillaries
- Optic nerve damage
- Formation of new blood vessels
- Vitreous hemorrhage
- Microaneurysms
- Formation of scar tissue/retinal detachment
If you doctor suspects that you have leaking blood vessels in the eye, he
or she may perform a test called fluorescein angiography. In this test, a
dye is injected into a vein in the arm, a blue light is used to observe
the eyes as the dye circulates. If the blood vessels are leaking, they
will appear bright yellow as the circulates.
Diabetic retinopathy can be successfully treated in most diabetics.
Although it cannot be cured, it can be kept under control such that
complete vision loss and reduced vision loss is kept to a minimum.
Resources: Find comprehensive coverage of
diabetic retinopathy from the National
Eye Institute. The Mayo Clinic offers images and explanations of how
diabetic retinopathy affects the retina. |
