Diabetic retinopathy: symptoms, treatment and how to prevent it

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Definition

What is diabetic retinopathy?

Diabetic retinopathy (diabetic retinopathy) is a complication of diabetes mellitus that attacks the retina of the eye.

This condition causes vision problems due to diabetes due to damage to the retinal blood vessels. The vessels in the damaged retina then swell and eventually bleed (leak) and eventually burst.

The retina is located in the nerve layer behind the eye and functions to capture light and send it in the form of signals to the brain to be processed into images.

Damage to the retina due to diabetic retinopathy causes vision deterioration over time. If the high sugar levels are left uncontrolled, this diabetes complication in the eye can lead to blindness.

How common is this disease?

Visual disturbances due to complications of diabetes are quite common. Of the approximately 285 million people with diabetes mellitus worldwide, about a third have signs of diabetic retinopathy.

Meanwhile, another third is life-threatening diabetic retinopathy.

Signs & symptoms

What are the signs and symptoms of diabetic retinopathy?

In its early stages, diabetic retinopathy may not show any symptoms or signs. The annoying symptoms usually appear only when the damage to the retina of the eye is severe enough.

When they do appear, the most common symptoms of diabetic retinopathy are:

• Look floaters, that is, dark thin dots or threads floating in vision
• Trouble seeing at night
• Blurred vision
• Difficulty distinguishing colors
• A dark, empty area appears in vision
• The object that is seen appears to be shaking or shaking, but in fact it is not
• Loss of the eye's ability to see

Symptoms above generally affect not only one side of the eye, but can also both.

When should I see a doctor?

If you experience any of the signs or symptoms mentioned above, immediately consult an ophthalmologist.

Next, do regular consultations with your doctor so you can monitor the progress of diabetes in your eyes.

Cause

What causes diabetic retinopathy?

Diabetic retinopathy is caused by damage to the blood vessels of the retina due to high blood sugar levels. Over time, high blood sugar levels can cause blockages so that the blood supply to the retina can stop.

When blood flow to the retina stops, your eye tries to grow new blood vessels. Unfortunately, these blood vessels do not grow properly and are prone to rupture.

According to the American Academy of Ophthalmology, based on the stage of development of the disease, diabetic retinopathy can be divided into:

1. Early diabetic retinopathy (non-ploriperative)

This complication of diabetes in the eye is also known as non-proliferative diabetic retinopathy.

In this condition, new blood vessels do not form, it's just that the walls of the blood vessels in the retina are weakened. After that, a small swelling (micro aneurysm) will form in the walls of the smaller vessels.

This condition sometimes causes fluid and blood to leak into the retina. As a result, the larger retinal blood vessels become enlarged and their diameter becomes irregular.

This type of diabetic retinopathy can develop from mild to severe. The more clogged blood vessels, the worse the condition will be.

The nerve fibers in the retina may also start to swell. Sometimes the center of the retina, called the macula, is also swollen. This condition is called macular edema.

2.End diabetic retinopathy (ploriperative)

Proliferative diabetic retinopathy means that complications caused by diabetes are getting worse.

In this condition, the damaged blood vessels will close, causing the growth of new blood vessels in the retina.

However, new blood vessels do not get optimal nutrition due to blocked blood flow. As a result of this abnormal growth, blood vessels easily leak into the center of the eye (vitreous), causing damage to eye tissue.

In addition, scar tissue from blocked blood vessels can be stimulated by the growth of new blood vessels. This condition can cause the retina to detach from the back of the eye (retinal detachment).

If new blood vessels interfere with the circulation of fluid from the eye, pressure can build up on the eyeball. This can damage the nerve that carries images from the eye to the brain (optic nerve) and result in glaucoma (large pressure on the eyeball).

Risk factors

What increases my risk of developing this disease?

You may be at increased risk of diabetic retinopathy if you have the following factors:

• Have had diabetes for a long time
• Poor control of blood sugar levels
• High blood pressure
• High cholesterol
• Pregnancy
• Smoke

Diabetics can slow the progression of this condition by reducing these risk factors.

Diagnosis

How is diabetic retinopathy diagnosed?

There are several methods to diagnose diabetic retinopathy, some of which are:

1. Dilation of the eye

This examination is performed using eye drops which will open the pupil wide. That way, the doctor can look inside your eye carefully.

At this stage, the doctor will check the eye condition, including:

• Abnormal blood vessels
• Swelling
• Blood vessel leak
• Blockage of blood vessels
• Wound
• Changes in the eye lens
• Nerve tissue damage
• Retinal detachment

2. A fluorescein geography

In this test, your doctor will inject a dye into your arm, allowing it to track how blood flows in your eye.

The doctor will take pictures of the dye residue swirling inside your eye to determine which blood vessels are blocked, leaking, or damaged.

3. Examination optical coherence tomography (OCT)

OCT is an imaging test that uses light waves to create images of the retina. This image allows the doctor to determine the thickness of the retina.

An OCT exam helps determine how much fluid, if any, has accumulated in the retina.

Treatment

The information provided is not a substitute for medical advice. ALWAYS consult your doctor.

What are the treatments for diabetic retinopathy?

Treatment for complications of diabetes in the eye will be adjusted according to the type experienced. If you have mild or moderate non-proliferative diabetic retinopathy, your doctor may not offer treatment right away.

However, the ophthalmologist will closely monitor your eyes to determine when is the right time to start treatment.

Meanwhile, if you have proliferative diabetic retinopathy or macular edema, surgery is needed immediately.

Based on the specific problem affecting the retina, these treatment options for diabetic retinopathy include:

1. Focused laser treatment

This laser treatment, also known as photocoagulation, can stop or slow down the leakage of blood and fluid in the eye.

In this procedure, leaks from the abnormal blood vessels are treated with laser heat.

2. Diffused laser treatment

This laser treatment, also known as panretinal photogoagulation, can shrink the abnormal blood vessels.

In this procedure, areas of the retina that are far from the macula are treated with diffused laser heat. This heat causes the abnormal new blood vessels to shrink and make an imprint.

3. Vitrectomy

This medical procedure uses a small incision in the eye to remove blood from the center of the eye (vitreous) as well as scar tissue that is pulling on the retina.

Treatment is carried out in a surgical center or hospital using local or general anesthesia.

Prevention

What are some lifestyle changes to prevent diabetic retinopathy?

One surefire way to prevent or slow down diabetic retinopathy is to keep blood sugar stable, aka managing diabetes.

The key is to control blood sugar levels to remain normal every day. Here are some of the lifestyle diabetics can do, especially to prevent complications of diabetes in the following eyes:

• Choose healthy foods for diabetes and keep your diet
• Doing regular exercise for diabetes that suits the conditions, such as walking, tai chi, cycling
• Check your blood sugar frequently as directed by your diabetes health care provider
• Routine control of blood sugar, blood pressure, and cholesterol is very important to prevent this condition
• Stop smoking and consult if it is difficult to quit this habit
• Follow the diabetes medication recommended by the doctor, be it taking diabetes medication or insulin therapy

Diabetic retinopathy is a complication of diabetes that causes damage to the retina of the eye.

This condition can cause serious vision problems and even lead to blindness. However, this eye complication can still be prevented or treated.

If you have any questions, consult your doctor for the best solution.