Diabetic Retinopathy

Diabetic RetinopathyDiabetic retinopathy is damage to retinal blood vessels as a result of high blood sugar levels caused by diabetes mellitus. There are two types of diabetic retinopathy. Nonproliferative diabetic retinopathy (NDPR) is an early stage of diabetic retinopathy in which tiny blood vessels within the retina leak blood or fluid causing the retina to swell or to form deposits called exudates. NPDR does not usually affect vision, but it may cause macular edema and/or macular ischemia, which do. Macular edema is a swelling of the macula, a small area in the center of the retina that controls perception of fine details. Macular ischemia occurs with the capillaries close and vision blurs because the macula no longer receives sufficient blood supply.

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Proliferative retinal retinopathy (PDR) is present when abnormal new vessels begin growing on the surface of the retina or optic nerve in response to the widespread closure of retinal blood vessels. Unfortunately, these new vessels do not resupply the retina with normal blood flow and they often produce scar tissue that may cause wrinkling or detachment of the retina. PDR causes visual loss in the following ways: Vitreous hemorrhage, the bleeding of the new vessels into the vitreous. If the eye does not clear the vitreous blood adequately within a reasonable time, vitrectomy surgery may be recommended; traction retinal detachment, the pulling of the retina from its normal position, which can cause visual distortion. More severe vision loss can occur if the macula or large areas of the retina are detached; neovascular glaucoma, increased pressure in the eye resulting from the growth of new abnormal blood vessels on the iris, which may cause pressure on the optic nerve. PDR may be treated by laser surgery or vitrectomy.

Vision loss as a result of diabetes is largely preventable as a result of improved methods of diagnosis and treatment. Early detection and diagnosis of diabetic retinopathy, as well as maintaining strict control of blood sugar levels, are the best protection against loss of vision. People with diabetes should schedule an examination at least once a year, more frequently after the diagnosis of diabetic retinopathy.