What is Diabetic Retinopathy?
Diabetic retinopathy starts to occur after the patient has had diabetes for five or more years. Many times a patient may not know that they have diabetes for several years. Diabetic retinopathy is caused by changes in the capillaries of the blood vessels. The integrity of the blood vessels is lost and the vessels can swell, form small aneurysms, and leak. This leads to damage to the retina in the back of the eye. The retina is responsible for capturing our vision and sending the image to the vision center of the brain.
Incidence of Diabetes in America
Diabetes has become an epidemic in the United States today. There may be as many as 30 million Americans with diabetes. Diabetic retinopathy is the leading cause of permanent blindness in people under the age of sixty.
Stages of Diabetic Retinopathy
Diabetic retinopathy is divided into two types of diabetic retinopathy.
Background or Non-Proliferative and Proliferative Diabetic Retinopathy
Mild Background Diabetic Retinopathy
At this stage there may be a few blot and dot hemorrhages and microaneurysms in the retina. The vision is not usually affected.
Moderate Background Diabetic Retinopathy
At this stage there are more blot and dot hemorrhages in the retina. There may be areas of hard exudates in the retina. This comes from the serum of the blood that leaks into the retina. Edema in the macula could start to decrease the vision. There may be areas of where there is loss of capillary perfusion. Loss of blood flow leads to the loss of vision.
Severe Background Diabetic Retinopathy
At this stage there is more bleeding into the retina. There may large areas of capillary non-perfusion which stimulates the retina to form abnormal fragile blood vessels that bleed into the retina and vitreous (gel-like substance that fills up the back portion of the eye). Patients can have significant vision loss at this stage.
Proliferative Diabetic Retinopathy
At this stage the development of abnormal vessels are growing into and on the retina. These fragile blood vessels bleed very easily and can cause significant damage. Abnormal tissue forms along with these vessels and causes traction retinal detachments. This stage of disease can cause complete loss of vision.
Symptoms of Diabetic Retinopathy
In the early stages of diabetic retinopathy there may be no symptoms. As the diabetic retinopathy progress the vision becomes blurred. If there is bleeding inside the eye, you may have tiny specks, spots, or floaters in the vision. Towards the end there may be severe loss of vision or total loss of vision.
Diagnosis of Diabetic Retinopathy
A comprehensive eye exam will show the evidence of diabetic retinopathy. The doctor may perform a fluorescein angiogram to evaluate the amount of diabetic retinopathy present. An OCT and photos of the retina may be taken to evaluate the condition of the retina.
Prevention of Diabetic Retinopathy
If you are diabetic, you should have a comprehensive eye exam once a year. If there is diabetic retinopathy present but does not need treatment, your eye doctor may want to see the patient more often. Controlling your blood glucose is very important as it has been shown that well controlled diabetic patients have less incidence of disease.
Diabetes and diabetic retinopathy is a leading cause of blindness. It is extremely important that everyone with diabetes have their eyes examined for diabetic retinopathy every year. Early detection and treatment if needed can save a person’s vision.