Diabetic Retinopathy

Diabetic retinopathy is a serious complication of diabetes that affects the retina. It is associated with blood vessel dysfunction on the retinal level.

What is diabetic retinopathy?

Diabetic retinopathy is a serious complication of diabetes that affects the retina. It is associated with blood vessel dysfunction on the retinal level.

Symptoms of diabetic retinopathy

In its early stages diabetic retinopathy is not accompanied by obvious symptoms, since the first retinal areas to be affected by vascular changes are peripheral. As the disease progresses, the macular region becomes involved, resulting in impaired visual acuity and the following possible symptoms in everyday situations:

  • Perception of dark spots or threads in front of the eyes (myodesopsias), especially on light backgrounds and in brightly lit environments;
  • Blurred vision when reading, using the computer, or walking;
  • You may have disturbances in colour perception (dyschromatopsia) during daily activities, as well as the appearance of “grey areas”, with a loss of visual acuity.

What do people with diabetic retinopathy see?

Diabetic retinopathy causes the development of “leopard spots”, blind areas, which may occur gradually or as a result of small haemorrhages.

Diabetic retinopathy: the causes

Diabetic retinopathy is one of the primary causes of reduced vision and blindness in developed countries (14% of visually disabled people according to WHO data).

The first trigger of diabetic retinopathy is diabetes, which, if not controlled, leads to abnormal growth of weak blood vessels, with less ability to transport oxygen to the retinal tissues.

The likelihood of diabeticretinopathy is higher the longer you have had diabetes. After 20 years of living with the disease, 70% of subjects develop retinopathy.

The stages of diabetic retinopathy

There are two stages of diabetic retinopathy, known as early diabetic retinopathy (also called non-proliferative diabetic retinopathy, NPDR), which can be classified as mild, moderate, or severe, and advanced diabetic retinopathy (also called proliferative diabetic retinopathy, PDR), which is the severest form.

Early diabetic retinopathy

As the disease progresses, early diabetic retinopathy involves weakening of the blood vessel walls, with possible microaneurysms, which can lead to bleeding or oedema (accumulation of fluid) in the central part of the retina (macula).

Proliferative diabetic retinopathy

In proliferative diabetic retinopathy, blood vessels located in the retina are subject to abnormal growth, stimulated by the formation of ischaemic areas in the retina. This can lead to retinal detachment or a build-up of fluid, which, by increasing eye pressure, can lead to glaucoma.

Diabetic retinopathy: treatments

To reduce the onset of diabetic retinopathy, the first solution is prevention. The main risk factor is determined by the degree of decompensated diabetes, that is, the glycaemic index and daily fluctuations (difference between maximum and minimum). Therefore, it is of utmost importance to check your blood sugar level periodically.

For people with diabetes, the ocular fundus should be checked regularly — even in the absence of symptoms — and specific examinations (such as fluorescein angiography and OCT) should be performed when necessary to assess the possible onset of the disease.

In the event that a blood effusion develops in the retinal tissue, therapy entails the same preparations used for maculopathy (or age-related macular degeneration), applied through intraocular injections.

The production of new vessels and tissue in ischaemic areas can lead to the risk of retinal detachment and the subsequent need for emergency surgery.

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