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Diabetic Retinopathy
Complications

Diabetic Retinopathy : Causes, Symptoms & Treatment

Diabetic Retinopathy

It is an eye disease that is caused by diabetes. Diabetic Retinopathy is caused when high blood sugar levels cause damage to the blood vessels in the retina. These blood vessels can close, stopping blood from passing through or can swell and leak. The retina is a light-sensitive membrane covering the back of the eye that sends signals to the brain via the optic nerve. Diabetic Retinopathy can develop in patients who have either type 1 or type 2 diabetes.

There are three different types of Diabetic Retinopathy

  • Background retinopathy
  • Diabetic maculopathy
  • Proliferative retinopathy

Diabetic Retinopathy

There are two main stages in Diabetic Retinopathy:

1.Non-proliferative Diabetic Retinopathy (NPDR):

It is the early stage of Diabetic Retinopathy. Most diabetes patients are affected by it. In the case of non-proliferative Diabetic Retinopathy, the blood vessels leak, leading to the swelling of the retina. Sometimes it also causes blood vessels in the retina to close off. NPDR leads to blurry vision and it is one of the most common reasons why diabetes patients lose vision. 

2.Proliferative Diabetic Retinopathy (PDR):

Proliferative Diabetic Retinopathy is the advanced stage of Diabetic Retinopathy. If the blood sugar blocks the blood vessels that go into the retina, it leads to leakage or bleeding of the blood vessels. Then, the eye grows new blood vessels which are weaker and are more prone to leakage or bleeding. This condition is called proliferative Diabetic Retinopathy.

PDR is a serious condition and leads to loss of both central as well as peripheral vision.

Causes of Diabetic Retinopathy:

There are two main causes that lead to Diabetic Retinopathy :

  • Fluid leaks into the macula. The macula is a small part of the retina that allows us to see colours and fine details. It is responsible for a clear central vision. The fluid causes swelling in the macula, resulting in blurry vision.
  • New blood vessels form on the surface of the retina to improve blood circulation. However, these abnormal blood vessels are fragile and can leak blood into the back of the eye resulting in the blockage of vision. 

Risk Factors of Diabetic Retinopathy:

  • Diabetes: People diagnosed with type 1 or type 2 diabetes are more likely to get Diabetic Retinopathy. A prolonged period of being affected by diabetes leads to Diabetic Retinopathy. After 20 years of diabetes, most of the patients are affected by retinopathy at least to some extent. 
  • Ethnicity: People belonging to a particular ethnic background are more likely to be affected by Diabetic Retinopathy.
  • Family History
  • Other prevailing medical conditions: High blood pressure and cholesterol increase risk.
  • Pregnancy: Pregnant women are more likely to be affected by retinopathy. 
  • Regular smoking 

Symptoms of Diabetic Retinopathy:

  • Blurry vision
  • Dark areas in the vision
  • Floating dark or empty spots in the field of vision
  • Double vision
  • Impaired colour vision
  • Poor night vision
  • Loss of vision
  • Eye pain

Symptoms of Diabetic Retinopathy

Complications:

Diabetic Retinopathy if left untreated can lead to serious consequences. Complications can lead to several vision problems:

  • Blindness: If untreated, Diabetic Retinopathy will eventually lead to blindness and complete loss of vision.
  • Glaucoma: The newly produced blood vessels interfere with the normal flow of fluid out of the eye. This leads to a build-up of pressure in the eye, which leads to the damage of the optic nerve.
  • Retinal detachment: Abnormal blood vessels stimulate the growth of scar tissues. These scar tissues pull the retina away from the eye. This leads to various vision problems.
  • Vitreous haemorrhage: The blood vessels bleed into the clear, jelly-like substance in the centre of the eye leading to floaters and in the severe case, leads to vision loss. 

Treatment of Diabetic Retinopathy:

The treatment for Diabetic Retinopathy depends on the severity of the condition. Different stages of Diabetic Retinopathy may require different types of treatment:

Laser treatment: 

Laser treatment also known as photocoagulation is done to reduce the swelling in the retina. Lasers are used to shrink blood vessels in the eye and also seal the leakages from abnormal blood vessels. This treatment either stops completely or slows down the leakage as well as the buildup of fluid in the eye.

Laser treatment

This treatment involves certain risks such as loss of night vision, colour vision and peripheral vision.  

Eye injections:

Medicinal injections in the eye are done to prevent the formation of abnormal blood vessels. Medicines like anti-VEGF drugs and corticosteroids can slow down or reverse Diabetic Retinopathy. The following steps are involved in the process of injecting medicines:

  • Numbing the eye by placing appropriate medicine
  • Cleaning the eye to prevent infections.
  • The medicine is placed in the eye using a very small needle

Surgery:

Sometimes the severity of the condition is so high that the doctors may recommend a vitrectomy. It involves the removal of some of the vitreous from the eye. The surgeon usually performs it under general or monitored anaesthesia. This treatment may not be the cure for Diabetic Retinopathy however, it stops or slows down the progression of the symptoms. This type of treatment is usually combined with other treatments. 

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