Diabetic retinopathy

Diabetic retinopathy

Table of Contents

What is diabetic retinopathy?

We often forget that diabetes is a major threat to our vision. Metabolic problems caused by diabetes can damage the retina. Diabetic retinopathy can cause hemorrhages, retinal vein occlusions, and macular edema (fluid accumulation between retinal layers in the center of vision).

Diabetic retinopathy can seriously affect your vision if it’s not monitored and treated. Without treatment, diabetic retinopathy can cause sudden vision loss leading even to blindness.

Diabetic retinopathy is, together with chronic kidney disease and peripheral neuropathy, the most frequent complication of diabetes mellitus and the leading cause of blindness in the working-age population (18-64).

In 2000, 4.06 million Americans were diagnosed with diabetic retinopathy. In 2010, increased to 7.69 million. In 2050, is projected to increase to over 14 million.

Normal retina
Proliferative diabetic retinopathy
Tractional retinal detachment due to diabetes

What are the symptoms of diabetic retinopathy?

This disease does not have any symptoms at onset. As the disease progresses, you may notice floaters or vision loss which are signs of a hemorrhage of the retinal veins.

Blurry vision in the center of the field of vision, difficulty reading, faded colors and visual distortion (objects look bent or wavy) can be signs of a macular edema.

Contact your Ophthalmologist immediately if you experience:

  • Gradually worsening vision
  • Sudden vision loss
  • Shapes floating in your field of vision (floaters)
  • Eye pain or redness
  • Difficulty seeing in the dark

These symptoms do not necessarily mean you have diabetic retinopathy, but it’s important to get them checked out. Do not wait until your next screening appointment.

Vision with diabetic retinopathy

If I have diabetes, how can I know if I have diabetic retinopathy?

All diabetic patients should have periodic eye exams, with a comprehensive exam of the retina by a specialist. The frequency of these eye exams depends on the damage to the retina and the stage of the disease. A patient with no damage or mínimum damage to the retina can be seen annually, however, if the damage is more severe the patient should be checked more frequently. Sometimes additional tests are needed.

Indirect ophthalmoscopy

IF YOU HAVE DIABETES, YOU SHOULD HAVE A COMPREHENSIVE EYE EXAM WITH A SPECIALIST REGULARLY.

Risk factors

  • Duration of diabetes
  • Poor glucose control
  • High blood pressure
  • Smoking
  • High cholesterol levels
  • High triglyceride levels

In general, more advanced retinal disease was found in patients with diabetes with worse glycemic and blood pressure control and longer duration of diabetes. Improvement in the control of blood pressure and glycemic control can have a beneficial effect on the ocular complications at any stage of retinopathy.

What is the treatment for diabetic retinopathy?

The best treatment for diabetic retinopathy is the proper control of diabetes. Blood pressure, cholesterol, and triglyceride levels should also be under control.

If you have proliferative or advanced diabetic retinopathy, it is important to treat it with photocoagulation with laser. This procedure can be done in the doctor’s office and can last between 15 and 30 minutes depending on whether one or both eyes are treated.

After laser treatment of diabetic retinopathy

In cases of diabetic macular edema (fluid accumulation between retinal layers in the center of vision), intravitreal injections are needed and can also be administered in the doctor’s office. These medications help stabilize the patient’s vision and even improve visual acuity.

Normal OCT (optical coherence tomography) scan of retina
OCT scan of diabetic macular edema

It is not always possible to treat advanced diabetic retinopathy with laser or intravitreal injections. In these cases, the treatment is a surgery called vitrectomy.

ONLY REGULAR EYE EXAMS WITH A SPECIALIST CAN DIAGNOSE AND EFFECTIVELY TREAT DIABETIC RETINOPATHY.

After vitrectomy and laser treatment
Vitrectomy in a diabetic patient
Entrevista Televisa Todo Acerca de la Retinopatía Diabética

References: Mayo Clinic Guide

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