Diabetic retinopathy (DR) is a complication resulting from diabetes. It affects the retina, a delicate part of the eye. DR occurs due to uncontrolled blood sugar, which damages the retinal vessels and leads to loss of vision if left untreated. This condition is also a leading cause of blindness in people between 20 – 64 years.
Diabetics retinopathy affects about 80% of people living with diabetes for 20 years or more. However, receiving the right care and having regular eye check-ups can reduce about 90% of new diabetic retinopathy cases.
Stages of diabetic retinopathy
Diabetic retinopathy has two main stages. They include:
- Non-proliferative diabetic retinopathy (NPDR)
- Proliferative diabetic retinopathy (PDR)
Non-proliferative diabetic retinopathy
NDRP usually shows no symptoms, and the only way to get a correct diagnosis is by examining the fundus. The fundus can be found inside the eye, opposite the lens, and behind it. The fundus contains blood vessels, macula, optic disc, retina, and fovea.
During the fundus examination, the doctor will check for accumulation of lipoprotein, bleeding, microaneurysms, and retinal vessel changes.
Proliferative diabetic retinopathy (PDR)
PDR causes the development of abnormal new blood vessels (neovascularisation). These new blood vessels develop at the back of the eye and may erupt and bleed, leading to vitreous haemorrhage or traction retinal detachment.
In some cases, macular oedema occurs, which is a swelling resulting from the build-up of fluid. Macular oedema may cause the blood vessels to leak their content into the central vision, leading to blurry vision during any stage of the condition.
When the retina is diseased (ischemia), it causes thesecretion of vascular endothelial growth factor, a protein that stimulates new blood vessel formation – these new blood vessels lead to retinal swelling (oedema).
Diagnosis of diabetic retinopathy
Diagnosis of diabetic retinopathy occurs through clinical examination and examination of the dilated fundus. Your doctor may also use a fluorescein angiography to check the extent of ischemia in the retina. This diagnostic test uses a special camera to track the flow of blood in the retina.
Another means of diagnosing DR is using Ocular Coherence Tomography (OCT), an imaging test that determines the location and size of the swelling in the macula area.
Managing diabetic retinopathy
Managing diabetic retinopathy involves the systemic control of factors associated with a higher risk of the disease. These high-risk factors include:
- Kidney problems
- Blood sugar
- Uncontrolled glucose
- Smoking
- High blood pressure (hypertension)
- Dyslipidaemia (irregular lipid volumes)
- Uncontrolled blood pressure levels
Studies from the Wisconsin Epidemiologic Study of Diabetic Retinopathy (WESDR) and the UK Prospective Diabetes Study (UKDPS) found these conditions to be risk factors for diabetic retinopathy.
Treatment of diabetic retinopathy
Treatment for diabetic retinopathy may include the following;
- Surgery in advanced cases
- Injections inside the eye (IVT)
- Laser treatment
Different studies from reputable organisations like the DRCR have shown that anti-VEGF (vascular endothelial growth factor) steroid injections cantreat central macular oedema, which occurs with diabetic retinopathy.
More extensive studies also showed that the anti-VEGF injection is not an inferior treatment to PRP laser, the gold standard treatment for proliferative diabetic retinopathy (PDR).
If you have diabetes, ensure you have regular check-ups to avoid other life-threatening conditions such as diabetic retinopathy.
If you are residing in London, book your private GP appointment today at Privatedoctor.london to see an experienced doctor if you have diabetes or diabetic retinopathy
