Patients with diabetes are at risk to develop diabetic retinopathy, a condition in which high or uncontrolled blood sugars damage the vessels in the retina. The vessels can swell and leak, close off and stop blood flow, or lead to growth of abnormal new vessels. Any of these complications can cause permanent loss of vision.
Diabetic eye disease can be categorized into two main stages: Non-Proliferative Diabetic Retinopathy (NPDR) and Proliferative Diabetic Retinopathy (PDR).
- Non-Proliferative Diabetic Retinopathy (NPDR): Many diabetics have ocular findings associated with this early stage of diabetic eye disease. Tiny blood vessels in the retina can develop microaneurysms and hemorrhage in different layers of the retina. Damaged blood vessels can also leak proteins and lipids (hard exudates), and cause retinal swelling. If swelling occurs in the macula (the functional center of the retina) and this macular edema in particular affects the fovea (the area of the macula responsible for sharp central vision), the patient will have reduced vision. Macular ischemia can develop if the vessels close off and prevent blood flow from reaching the macula.
- Proliferative Diabetic Retinopathy (PDR): This advanced stage of diabetic eye disease occurs because abnormal blood vessels inadequately perfuse and oxygenate the retina, so new blood vessels form in the retina, a process called neovascularization. These vessels, however, are fragile and often bleed into the eye causing floaters and/or hazy vision. Fibrovascular tissue can develop, cause traction on the retina and lead to a retinal detachment.
The development of diabetic retinopathy is best avoided with consistent glucose control. Diabetic patients should have dilated eye examinations at least yearly because diabetic retinopathy can be detected before the onset of associated visual problems.
Intravitreal injections of anti-VEGF (anti-angiogenic) medications such as Lucentis, Eylea, or Avastin can treat some stages of diabetic retinopathy, but recent studies have shown that not all patients respond well to this type of treatment. Laser treatment, vitrectomy (removal of the gel with non-clearing hemorrhage from the back of the eye), or retinal detachment repair may be indicated, depending on the severity of the disease progression.
Call today to schedule a dilated eye examination (702) 896-2020.