The cells in persons with diabetes mellitus have difficulty using and storing sugar
properly. When blood sugar gets too high, it can damage the blood vessels in the
eyes. This damage may lead to diabetic retinopathy.
The two types of diabetic retinopathy are Proliferative diabetic retinopathy and
Non Proliferative diabetic retinopathy
PROLIFERATIVE DIABETIC RETINOPATHY:
New, fragile blood vessels grow on the surface of the retina. These new blood vessels
are called neovascularization, and can lead to serious vision problems, because
the new vessels can break and bleed into the vitreous. When the vitreous becomes
clouded with blood, light is prevented from passing through the eye to the retina.
This can blur or distort vision and frequently causes sudden and severe loss of
vision. The new blood vessels can also cause scar tissue to develop, which can pull
the retina away from the back of the eye. This is known as retinal detachment, and
can lead to blindness if untreated. In addition, abnormal blood vessels can grow
on the iris (the colored part in the front of the eye), which can lead to severe
NON-PROLIFERATIVE DIABETIC RETINOPATHY:
Background or nonproliferative diabetic retinopathy - blood vessels in the retina are damaged and can leak fluid or bleed. This causes the retina to swell and form deposits called exudates.
Many patients may not notice any change in their vision when they develop this early form of the disease, but it can lead to other more serious forms of retinopathy that severely affect vision. Fluid collecting in the macula is called macular edema and may cause difficulty with reading and other close work.
Treatment of Diabetic Retinopathy:
Good control of diabetes with intensive management and control of blood sugar will
delay, and possibly prevent, both the development and progression of diabetic retinopathy.
Patients with diabetic retinopathy frequently need to have special photographs of
the retina taken. This series of photos is called fluorescein angiography.
Laser photocoagulation is one of the most common treatments for diabetic
retinopathy. Focal photocoagulation consists of laser directed at the retina to
seal leaking blood vessels in patients with background diabetic retinopathy. Panretinal
photocoagulation consists of laser spots scattered through the sides of the retina
to reduce abnormal blood vessel growth (neovascularization) and help seal the retina
to the back of the eye in patients with proliferative diabetic retinopathy. This
can help prevent retinal detachment. There is little recuperation needed after laser
surgery for diabetic retinopathy. Laser surgery may require more than one treatment
to be effective.
Vitrectomy surgery is performed for patients with very advanced proliferative
diabetic retinopathy or retinal detachment. In vitrectomy, the surgeon removes the
blood-filled vitreous and replaces it with a clear solution. This allows light to
pass through the clear fluid to the retina, where the images are conveyed to the
Pharmacotherapy: Increasingly, a variety of medications are being used to
treat the manifestations of background and proliferative diabetic retinopathy.
These involve intravitreal injections of small amounts of medication into
The type of retinopathy, as well as the patient's general health and eye structure
will determine the kind of treatment needed and the type of anesthesia utilized.