Diabetic Retinopathy: A Threat to Your Vision

     'Diabetic retinopathy' The incidence of diabetes continues to rise every year. According to the International Diabetes Federation (IDF), there are currently 537 million people with diabetes worldwide, with over 90% having type 2 diabetes. Nearly half remain undiagnosed, and it is projected that by 2030, the number will increase to 643 million and 783 million by 2045.

In Thailand, the trend is similar, with 3.3 million cumulative cases reported in 2022, and in 2023, an additional 300,000 new cases were identified. 

Diabetes: Consequences of Eye Disease

     These statistics emphasize the importance of managing and monitoring diabetes and preventing its complications, which could lead to significant losses, including diabetic retinopathy, a complication affecting the eyes. This is a serious condition that, if left unchecked, can cause permanent vision loss, but it can be easily screened for.

Diabetic retinopathy

     Diabetic retinopathy is a complication of diabetes that affects the eyes. Long-term high blood sugar damages blood vessels throughout the body, including those in the retina. The risk of developing diabetic retinopathy increases with the duration of diabetes and prolonged high blood sugar levels.

Read more: Diabetes in Children: An Increasingly Common and Complex Issue.

Stages of Diabetic Retinopathy

1.  Non-proliferative Diabetic Retinopathy (NPDR)

     In this stage, the blood vessels in the retina weaken, resulting in possible retinal hemorrhages, fluid accumulation, and swelling in the peripheral retina. Some blood vessels may also leak in the macula, leading to blurry vision.

2.  Proliferative Diabetic Retinopathy (PDR)

     In its advanced stage, diabetic retinopathy leads to retinal ischemia as damaged blood vessels fail. This triggers the growth of fragile new vessels (neovascularization) that can bleed, causing retinal tears, macular swelling, and blindness. These new vessels can also obstruct fluid drainage, increasing intraocular pressure and leading to glaucoma.

Symptoms of Diabetic Retinopathy

Diabetic retinopathy often has no symptoms, even in advanced stages, leading patients to neglect eye examinations. It is usually only discovered when the condition is severe and symptoms appear.

• Reduced vision
• Seeing dark spots or floaters, or a reddish haze in the visual field
• Distorted vision
• Difficulty distinguishing colors

Diagnosis of Diabetic Retinopathy

     Diabetic patients should undergo regular eye exams, including pupil dilation or retinal imaging, even if they experience no visual symptoms. This screening should occur annually or as directed by an ophthalmologist. Diabetic women who are pregnant should also have an eye examination within the first trimester, as hormonal changes during pregnancy can worsen diabetic retinopathy.

Treatment of Diabetic Retinopathy

1.  Laser Treatment 

     A laser is used to shrink new blood vessels and control leakage. Laser treatment should be done before extensive bleeding obscures the retina. Multiple sessions may be necessary to prevent retinal swelling from the laser. Laser treatment can improve vision depending on the severity of retinopathy, but it may result in peripheral vision loss as a side effect.

2.  Intravitreal Injection

     Intravitreal Injections into the vitreous cavity help inhibit new blood vessel growth and reduce retinal swelling. This method is increasingly common as it can improve vision without compromising peripheral vision. However, the effects are temporary, and risks such as infection, vitreous hemorrhage, and retinal detachment may occur, though the risk is less than 1%.

3.  Vitrectomy

     In cases of retinal detachment, chronic vitreous hemorrhage, or retina distortion due to scar tissue, vitrectomy surgery may prevent disease progression and restore the retina to its original position. Vision outcomes vary based on disease severity in each patient.

The Prevention of Diabetic Retinopathy

• Control blood sugar, lipid levels, and blood pressure within normal ranges, through consistent medication and lifestyle changes in diet and exercise.
• Avoid smoking and alcohol.
• Regularly monitor for visual changes and see an ophthalmologist if vision decreases or abnormalities arise.
• Undergo annual diabetic retinopathy screening or as recommended by a doctor

Summary

     Diabetic patients should undergo regular eye exams, including pupil dilation or retinal imaging, even if they experience no visual symptoms. This screening should occur annually or as directed by an ophthalmologist. Diabetic women who are pregnant should also have an eye examination within the first trimester, as hormonal changes during pregnancy can worsen diabetic retinopathy.

For more information please contact:
 Ophthalmology Department, 1^st Floor, RAM 2 Hospital
Email: information@ram2-hosp.com
Line Official: @ram2
Tel: 02-032-3888

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