Diabetic Retinopathy

What is Diabetic Retinopathy ?

Diabetic retinopathy is a complication of diabetes and a cause of blindness in Australia and worldwide. It results from damage to the fine blood vessels behind the eyes as a result of the diabetes. Bleeding or haemorrhage occurs when the new weakened blood vessels form and cannot sustain normal flow. Fluid can leak into the macular area which is responsible for clear, central sight. This in turn causes swelling or cystoid macular oedema (CMO). A healthy macula and retina are both vital for good vision.

Symptoms

Diabetic retinopathy often has no early warning signs, and can progress rapidly undetected. If you are a type 1 or type 2 diabetic, a yearly examination with your eye doctor is essential for diagnosis. Progressive symptoms may include:

• Blurred or distorted vision as the disease progresses
• Glare sensitivity and difficulty seeing at night

Diagnosis

Annual eye examinations are essential for anyone with type 1 or type 2 diabetes, since retinopathy often has no early symptoms. The vision is checked and documented using an eye chart. The eye pressure is taken using numbing drops. The pupils are then dilated with a second drop. The doctor uses a microscope with a special lens to view the retina and the blood vessels out to the periphery. Any haemorrhages are noted and often retinal photography is used to monitor changes from one visit to the next.

Treatments

During the early stages there is no treatment required unless you suffer from cystoid macular oedema (CMO). If retinal haemorrhages occur then:

• Intravitreal injections — a painless procedure where anti-VEGF drugs are injected into the eye to block the protein responsible for the growth of new blood vessels, administered at four week intervals.
• Laser therapy — seals leaking blood vessels to prevent further vision loss

Outcomes

Gradual improvement in vision can be seen over weeks or months. Laser treatment can help dry up the peripheral retina and help seal fine leaks.

The ultimate outcome of treatment depends on the severity and progression of the diabetic retinopathy. Early detection and treatment are vital. The best prevention is well controlled diabetes through healthy eating and exercise. Normal range blood sugar levels, blood pressure and cholesterol all help to prevent this eye disease and control its progression.