Diabetic Retinopathy, is the leading cause of blindness in patients 20 to 74 years in the United States, and is caused by complications of diabetes. Diabetes is a group of metabolic diseases that affect the body’s blood sugar levels, either because the body does not produce enough insulin or because cells do not respond to the insulin that is being produced. High blood sugar levels lead to damage of the small blood vessels in the eyes and kidneys as well as other organs. When the blood vessels in the retina become damaged due to diabetes, it is called diabetic retinopathy.
Though diabetic retinopathy often has no early warning signs, the most common signs are blurred vision and specks of blood, or floaters, that are seen floating in the visual field. This early stage of diabetic retinopathy is called non-proliferative diabetic retinopathy, which occurs when blood vessels leak and fluid accumulates in the retina. Monitoring of the retina is crucial to prevent further damage. A doctor is able to detect the damage to the fine blood vessels of the retina caused by diabetes as distortion of the vessels and small retinal hemorrhages.
Monitoring the retina is essential in preventing proliferative diabetic retinopathy, which occurs when the retina begins releasing stimulants for the growth or proliferation of new blood vessels. The new vessels are fragile and can easily bleed into the vitreous cavity, causing severe loss of vision, which is the condition called diabetic macular edema. Diabetic macular edema can permanently damage the retinal nerve cells, if left untreated.
Laser surgery combined with injectable anti-inflammatory medications into the eye can be used to stop leakage and reduce swelling caused by diabetic macular edema. These treatments may be ongoing, as this condition is typically recurring. While these treatments can aide in making vision better, gaining control over blood sugar levels is essential in preventing further damage.
As diabetic retinopathy progresses into proliferative diabetic retinopathy, where new and fragile blood vessels are created, severe bleeding known as a vitreous hemorrhage becomes a risk. This hemorrhaging of the blood vessels causes blurred and spotted vision and can lead to detachment of the retina, which can cause blindness. In this case, a more aggressive laser treatment is needed called a vitrectomy. A vitrectomy is a microsurgical procedure to restore vision after a vitreous hemorrhage by clearing scar tissue and blood from the eye or reattaching the retina.