What is Diabetic Retinopathy?

Board-certified Jacksonsville retina specialists, Dr. John Sullivan and Dr. Shawn Agee, recommend regular eye examinations for the general population, but especially for diabetic patients. Regardless of which type of diabetes a patient suffers from (type 1 or 2), a common complication is diabetic retinopathy. This eye condition refers to damage in the blood vessels of the retina, which is located in the back of the eye. Factors that most contribute to diabetic retinopathy is having less controlled blood sugar and suffering from diabetes for a longer period of time. While the condition may be mild with few or no symptoms initially, symptoms can worsen over time and even cause blindness. In fact, diabetic retinopathy is credited as the top reason for vision problems among diabetics, as well as the main cause for blindness among working-age adults.

There are 4 stages of diabetic retinopathy:

1. Mild nonproliferative retinopathy – tiny areas of swelling in the blood vessels of the retina appear.
2. Moderate nonproliferative retinopathy – blood vessels become swollen and distorted and may not be able to transport blood.
3. Severe nonproliferative retinopathy – increasing numbers of blocked and damaged blood vessels and growth of new vessels are apparent.
4. Proliferative retinopathy – growth of new blood vessels that are weak and can lead to leaking and bleeding, which can cause vision loss.

Causes and Symptoms

Diabetic retinopathy is a direct result of having diabetes, where chronic high blood sugar episodes have caused damage to the blood vessels in the retina. The retina is a layer of tissue found in the back of the eye which consists of light-sensitive tissue that’s responsible for detecting light. In turn, diabetic retinopathy can lead to diabetic macular edema (DME), which causes fluid to build-up in the central portion of the retina, the macula, which can lead to vision problems.

While there are usually no symptoms in the early stages of diabetic retinopathy, symptoms can gradually progress. Common symptoms are:

• Vision problems, including distortion and blurriness
• Decrease in visual acuity (sharpness)
• Appearance of floaters
• Vision loss
• Decreased color vision

Diagnosis

Diabetics should regularly visit their eye doctor for routine comprehensive eye exams to check for any problems. The doctor will use the visual acuity test, utilizing an eye chart to determine how well a patient can see at various distances. With tonometry, the ophthalmologist will measure the pressure within the eye to see if there are any abnormalities. Pupil dilation widens the pupil so your doctor can get a better view of your retina to see what’s going on with the area. With optical coherence tomography (OCT), light waves are used to capture detailed images of the retina.

In certain cases, your doctor may choose to use fluorescein angiography where you will be injected with a special dye that will go into your bloodstream. The fluorescent dye will highlight blood vessels in the retina to determine if any there’s any bleeding, leaking, or damage present.

Treatment and Prognosis

Drugs like corticosteroids are often given to patients suffering from diabetic retinopathy to alleviate symptoms, such as inflammation. The medications can be injected or implanted into the eye for a continuous delivery. Laser treatment uses laser technology to target and burn damaged and leaking blood vessels to prevent further leaking and to decrease inflammation. Anti-VEGF drugs are injected into the eye in the vitreous gel. The drugs work to block a certain protein that’s responsible for the growth of abnormal blood vessels which can leak fluid.

Although in certain cases there’s no way to reverse vision loss or blindness, most patients can expect about a 95% reduction in the occurrence of blindness with an early diagnosis and proper treatment. Controlling diabetes by keeping blood sugar levels intact is one of the best ways to prevent or slow down the progression of diabetic retinopathy.

Treat Diabetic Retinopathy

It’s especially important for diabetics in general and pregnant diabetic patients in particular to get routine eye exams to prevent complications. Since diabetic retinopathy is so common, we perform comprehensive eye exams for our diabetic patients. To schedule your eye exam, contact our office as soon as possible.