Ask the Expert: Diabetic Retinopathy
What is diabetic retinopathy?
Diabetic retinopathy refers to changes related to blood vessels in the retina that result when somebody has diabetes. The stage of diabetic retinopathy is correlated with one’s glycemic control (i.e., higher blood sugar often results in more advanced eye disease). These changes can vary from mild and not vision-threatening (non-proliferative diabetic retinopathy) or they can be more severe and lead to significant vision loss (proliferative diabetic retinopathy). Diabetes can also cause reduced vision through a process known as diabetic macular edema, where leaky blood vessels cause swelling and affect the functioning of the central retina.
What are the warning signs of diabetic retinopathy?
In earlier stages (and sometimes even into much later stages), patients can be asymptomatic. That is why it is critical for diabetic patients to be screened for diabetic retinopathy with an annual dilated eye exam. Patients who have diabetic macular edema often see an eye provider because their vision is blurry. In proliferative diabetic retinopathy, where abnormal vessels grow and bleed, patients can present with new floaters in their vision (called vitreous hemorrhage).
When should you see an eye doctor about symptoms?
A dilated eye exam is advisable for any patient who is experiencing a new change to their vision. A delay in diagnosis and treatment can result in significant loss of vision in some cases.
What can be done to fix it?
Fortunately, there are several treatments available for the management of diabetic retinopathy and diabetic macular edema. Intravitreal injections (injections of medication into the eye) and/or laser are therapies used to manage these conditions in the clinic. These treatments have been thoroughly investigated across numerous clinical trials are widely considered to be effective and safe. These interventions tend to be more frequent at the beginning of a patient’s treatment course and lessen over time. In more advanced disease, clinical management alone is not sufficient, and surgery is indicated. Because diabetic retinopathy is never truly cured, it is important for patients to follow-up at appropriate intervals for monitoring and treatment if needed.
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