Diabetic Retinopathy

Home » Diabetic Retinopathy » Diagnosis, Treatment, Prevention

Diagnosis

Early detection of diabetic retinopathy is possible with a dilated fundus examination performed by an ophthalmologist or an optometrist. (links) By dilating, or enlarging, the pupil with medicated eye drops, the practitioner can examine the back of the eye, or fundus, where the retinal blood vessels and arteries are located. In a darkened examination room, the practitioner uses an ophthalmoscope to focus a beam of light through the pupil and looks through the instrument's magnifying lens to inspect the retina for fluid buildup, swelling, damaged optic nerve tissue, and changes in and/or leaking blood vessels.

Fluorescein angiography is used if macular edema or other retinal problems are suspected. A small amount of dye is administered via an intravenous infusion and photographs of the retina are taken with a special camera as the dye passes through the blood vessels.

Treatment

Laser Surgery
The argon laser beam can be used to treat macular edema and proliferative retinopathy. While the underlying mechanism of action is somewhat debatable, argon laser treatment can reduce the risk of moderate vision loss in patients with macular edema and reduce the risk for severe visual loss in patients with proliferative diabetic retinopathy. Laser treatment may not be able to reverse visual loss that has already occurred and may need to be repeated if diabetic retinopathy progresses.

Neovascularization is stopped and new growth prevented. Vision loss is stabilized, although usually not improved. Scatter laser treatment is not effective if bleeding is severe or if the retina is detached. There are side effects with this procedure, including increased difficulty with night vision and the loss of peripheral vision.

Vitrectomy
Vitrectomy is performed on patients who are not candidates for laser surgery because of extensive bleeding in the eye. Blood, scar tissue, and other debris that forms in the vitreous body as a result of advanced retinopathy obscures the path of light to the retina, resulting in blurred vision. Removing the vitreous clears vision and may prevent retinal detachment.

Vitrectomy can be performed on patients with more severe complications of diabetic retinopathy such as vitreous hemorrhage or traction retinal detachment.

Prevention

Patients who maintain good control of their blood sugar level have a significantly lower risk for retinopathy. Diagnosing retinopathy early can help prevent complications and advanced disease. Patients with diabetes should have regular, comprehensive eye examinations at least once a year. If retinopathy has developed, more frequent exams may be necessary.

To prevent vision loss, people with diabetes should take the following measures:

• Avoid smoking (can lead to circulatory problems).
• Have regular eye exams.
• Keep blood glucose levels under control.
• Keep blood pressure under control through diet, lifestyle changes, or medication.
• Report blurred vision, eye pain, or blood in the eyes immediately.
• Use prescription eye drops as directed.

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