Patients often ask me, “What is diabetic retinopathy?” This question usually comes up after an eye exam reveals something they weren't expecting. It’s a fair question and deserves more than a mere definition, so what is diabetic retinopathy? Let's clear up your questions. Diabetic retinopathy is one of the most common potentially serious eye diseases that can affect anyone with diabetes. The upside? It’s treatable, and like anything else, it’s manageable and often preventable if it’s caught early and treated appropriately.
Covering the bases; what is diabetic retinopathy?
Diabetic retinopathy primarily develops because of damage to tiny blood vessels of the retina, the tissue that receives and processes light at the back of the eye. If you have high blood sugar for a long period, this causes blood vessels to become weak, leak, or become blocked. The longer this goes ignored, the more it can affect your vision and even lead to blindness.
In diabetic retinopathy, there are two primary stages: non proliferative diabetic retinopathy (NPDR) which occurs in the early stage, and proliferative diabetic retinopathy (PDR), which is a more advanced stage. In the NPDR stage, blood vessels swell and leak fluid, and in the PDR stage, new, abnormal blood vessels grow and can cause scar tissue and damage to the retinal tissue, among other problems.
Diagnosis and Treatment Options
Diagnosing diabetic retinopathy is quite simple. During an eye exam, I use a specialized lens and different imaging tools to actually look at the retina. Depending upon what I see, I may perform fluorescein angiography to look for fluid leaks or abnormal vessels, or OCT retinal scans to look for fluid buildup.
The treatment plan will depend on the stage of the disease. In the beginning, good control of blood sugar, blood pressure, and cholesterol may be enough to halt and even reverse changes. As it progresses, I may recommend:
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Intraocular Injections (Anti-VEGF Therapy)
Intraocular injections are a form of anti-vascular endothelial growth factor (anti-VEGF) medication that is injected directly into the eye. The goal of the treatment is to slow down the action of VEGF, a protein that promotes the growth of blood vessels in the retina that is not normal but is a byproduct of retinal ischemia. The anti-VEGF therapy decreases the growth and leakage of these abnormal blood vessels to reduce the effect of diabetic retinopathy and preserve vision.
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Laser Photocoagulation
Laser photocoagulation is a procedure that uses a laser to deliver precise doses of focused light to the retina, causing small burns on the retina. In the case of diabetic retinopathy, photocoagulation seals leaking blood vessels and can stabilize against worsening visual loss and bleeding.
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Vitrectomy Surgery
Vitrectomy surgery is a surgical procedure that removes vitreous gel from inside the eye. Vitrectomy surgery is frequently required for cases of diabetic retinopathy where there has been too much bleeding, or scar tissue has reduced vision and is invasive. By removing the vitreous, I can then address problems in the retina and potentially correct visual outcomes for patients with damaging aspects of the disease.
Each treatment plan is personalized to a specific person, but again, the sooner we begin the treatment, the more vision we can preserve.
Final Thoughts: Don’t Wait for Symptoms
If you’re living with diabetes, don’t wait until your vision blurs to ask, “What is diabetic retinopathy?” Ask now. Learn now. Act early. As someone who’s treated thousands of patients with this condition, I can tell you: the earlier we intervene, the better your outcome.
Vision loss from diabetic retinopathy doesn’t have to be your story. With awareness, prevention, and regular checkups, it’s a complication you can stay ahead of.