Diabetic Retinopathy

Despite these intimidating statistics, research indicates that at least 90% of these new cases could be prevented & treated with proper and vigilant treatment and monitoring of the eyes.

An over accumulation of glucose and/or fructose damages the tiny blood vessels in the retina. During the initial stage, called non-proliferative diabetic retinopathy (NPDR), most people do not notice any change in their vision. As the disease progresses, severe non-proliferative diabetic retinopathy enters an advanced, or proliferative (PDR), stage when blood vessels proliferate. This may cause bleeding inside the eye and obscures the vision. Even so, the advanced proliferative diabetic retinopathy (PDR) can remain asymptomatic for a very long time, and so should be monitored closely with regular check-ups.

Diagnostic Eye Examinations Include:

Visual acuity test: This test uses an eye chart to measure how well a person sees at various distances 
Pupil dilation: The eye care professional places drops into the eye to widen the pupil. This allows him or her to see more of the retina and look for signs of diabetic retinopathy. After the examination, close-up vision may remain blurred for some time.

Ophthalmoscopy or fundus photography: Ophthalmoscopy is an examination of the retina in which the eye care professional: (1) looks through a slit lamp biomicroscope with a special magnifying lens that provides a narrow view of the retina, or (2) wearing a headset (indirect ophthalmoscope) with a bright light, looks through a special magnifying glass and gains a wide view of the retina. Fundus photography generally recreate photo documentation for future reference, as well as availing the image to be examined by a specialist at another location and/or time.

Fundus Fluorescein angiography (FFA): This is an imaging technique which relies on the circulation of Fluorescein dye in the eye vasculature.

Optical coherence tomography (OCT): This is an optical imaging modality used to measure the thickness of the retina and to resolve its major layers, allowing the observation of swelling and or leakage

Diabetes Retinopathy Treatments

There are three major treatment for diabetic retinopathy:

Laser photocoagulation: It can be used in two scenarios for the treatment of diabetic retinopathy. It can be used to treat macular edema (centre part of retina which is responsible for maintaining vision) and it can be used for panretinal coagulation for controlling neovascularization (Growth of new blood vessels on the retina).

Intravitreal Injection of Anti-VEGF or Corticosteroid: Multiple clinical trials have shown that intravitreal (Inside the vitreous gel) injections of Anti-VEGF (Vascular Endothelial Growth Factor) is beneficial in the treatment of diabetic macular edema and has been effective in improvement of vision. Corticosteroids are also used in limited and certain scenarios. Even though it is effective, increased intraocular pressure (Glaucoma) is its major disadvantage. Present recommended treatment for diabetic macular edema is Modified Grid laser photocoagulation combined with multiple injections of Anti-VEGF.

Vitrectomy: In some people, instead of laser photocoagulation, may require surgery to treat retinopathy and improve vision. This often performed whenever there is blood in the vitreous gel or traction on the retina causing retinal detachment. Surgery is performed with micro-instrument . Latest instrumentation has improved postoperative recovery period a great deal.