Diabetic Retinopathy

According to the National Eye Institute, it is estimated that nearly 5.4 million Americans, ages 18 and over currently have diabetic retinopathy. This eye disease causes over 8000 cases of new blindness annually, and is the primary cause of blindness for people ages 25 to 74 (Valero and Drouilhet, 2001).

Every patient with diabetes needs a dilated eye exam at least once a year.

What is diabetic retinopathy?

Diabetic retinopathy is a leading cause of blindness in American adults. In the majority of diabetic retinopathy cases, blindness is completely preventable. Patients will need to work closely with their Thomas Eye Group diabetic retina eye doctors to monitor and treat this disease. The use of medications and daily blood sugar monitoring can make a major impact on preventing or containing any worsening of diabetic retinopathy.

The retina is the like the film in a camera; the light sensing film on the inside, back of the eye that captures the images. In the diabetic, sugar (glucose) builds up within blood vessels in the retina and tissues of the body causing it to attach to the proteins in the wall. This alters the vessel’s normal structure and functioning. The vessels eventually get blocked and leak fluid. When they cannot deliver an adequate amount of blood supply to the eye, the eye can generate abnormal new blood vessels. Early diabetic retinopathy usually has no symptoms. However, worsening diabetic retinopathy can lead to visual loss and blindness.

The stages of diabetic retinopathy are divided into two categories, nonproliferative retinopathy and proliferative retinopathy.

Nonproliferative Retinopathy

This is the first and earliest stage of diabetic retinopathy. NPDR (non-proliferative diabetic retinopathy) occurs when the small blood vessels of the retina start to leak fluid or bleed. This activity will lead to the formation of deposits called exudates. Once these blood vessels start to leak, swelling within the central part of the retina can occur. When the leakage of these blood vessels causes swelling of the central vision, this is referred to as macular edema. When macular edema sets in, the blood vessels can become blocked. This stage of diabetic retinopathy is common when a person develops diabetes. Most diabetics have some grade of NPDR. It is imperative to maintain regular eye examinations with the retina specialists at Thomas Eye Group to monitor and treat NPDR.

Proliferative Retinopathy

When new vessels start to grow as a result of the existing vessels becoming blocked, this marks the beginning of the next stage of diabetic retinopathy, proliferative diabetic retinopathy. This level of diabetic retinopathy is the most severe and dangerous for the diabetic patient. These new abnormal blood vessels can grow on the retina, optic nerve, iris or into the vitreous gel inside the eye, and tend to grow poorly and are very fragile. The damage that these blood vessels bring to retina can be catastrophic and include hemorrhages on the retina, scar tissues build up, and possible retina detachment. Proliferative diabetic retinopathy can be present without any visual symptoms.

Diabetic Retinopathy Symptoms

• If you are a diabetic patient, it is suggested by the Thomas Eye Group that you have yearly dilated eye exams (regular eye exams to look for symptoms. Diabetic retinopathy does not really have any initial warning signs. )
• Retinal swelling may cause blurred vision and distortion.
• Objects may look smaller or larger than normal
• Floaters may appear due to the bleeding of the blood vessels.

*If proliferative diabetic retinopathy is left untreated blindness can occur. The best alternative to fighting PDR is early detection so that you and your eye doctor can begin to control this development.

Early detection saves vision!
How does the Thomas Eye Group detect diabetic retinopathy?

The doctors at Thomas Eye Group will detect diabetic retinopathy through regular eye exams with their diabetic patients. In the earliest stages of diabetes, eye exams once or twice a year may be acceptable. The doctors will be specificly looking for the leaking blood vessels that can lead to more advanced levels of this eye disease. A dilated eye exam will be performed by your eye doctor and retinal photographic equipment may be used.

Diabetic retinopathy treatments:

• Laser treatments - These laser treatments are also known as photocoagulation. The laser is uses controlled bursts to seal leaking blood vessels, destroy abnormal blood vessels, seal retinal tears
• Intraocular corticosteroids – Many studies have been conducted recently with these types of injections. They may reduce retinal swelling and improve visual acuity in patients with diabetic macular edema.
• Intravitreal Avastin^™ – Avastin^™ has been previously mentioned regarding macular degeneration treatments, but Avastin^™ may also be used in cases of diabetic retinopathy. A variety of retina conditions can be treated with intravitreal Avastin^™ including, proliferative and non-proliferative diabetic retinopathy, macular degeneration, macular edema, and retinal vein occlusions. The objective of the Avastin^™ is ultimately to prevent further vision loss. Some patients have reported some regained vision but the medication should not be expected to restore vision that has already been lost due to macular degeneration.
• Vitrectomy - A vitrectomy may be performed to clear blood and debris from the eye, to remove scar tissue, or to alleviate traction on the retina. The Vitrectomy actually removes vitreous gel from the eye through a small incision. Vitrectomy allows the retina to flatten. Depending on the severity of the diabetic retinopathy, gas, air, or silicone oil might be placed in the eye to replace the vitreous fluid that was removed. This gas or air helps smooth out the retina and prevent retinal detachment.

Learning to live with diabetes and diabetic retinopathy Essential nutrition tips for Atlanta diabetic retinopathy patients

If you are diabetic patient you have most likely had some kind of discussion with your primary care doctor regarding diet. The nutrition of the food you eat becomes critical for maintaining proper blood sugar levels. Please refer to this list below for diabetic nutrition tips:

• Drink water (8 glasses per day)
• Reduce artificial fats
• Juice and vegetables
• Increase fiber intake
• Reduce caffeine or refined sugar

The doctors at Thomas Eye Group would like all diabetic patients to know that we care and hope that we can provide the best care for their eyes. Most people who are diagnosed with diabetes are not told of the dangers related to the eyes, but instead are told about other problems like strokes, heart attacks and kidney disease. Our eye doctors want you to know that early detection can save your vision and we are here to help in any way possible. We hope that you have found our information on diabetic retinopathy useful. For diabetic eye examinations please contact one of our multiple Atlanta area locations.

Our Retina Specialists

Our retina specialists are board-certified in ophthalmology and fellowship-trained as specialists in retina/vitreous medicine and surgery.  Both have also been recognized throughout their careers, by colleagues and patients, for compassionate patient care and surgical skill.

Dr. Paul L Kaufman, M.D.

Dr. Jessica D. McCluskey, M.D.