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Early Management of Diabetic Retinopathy Can Prolong Your Vision

What is Diabetic Retinopathy?

Damage to the retina in the eyes caused by complications from diabetes mellitus is called diabetic retinopathy. As an ocular disorder manifested by a systemic ailment, it can lead to total blindness afflicts 80% of patients who has suffered diabetes over the last 10 years or so. However, recent research indicates that at least nine out of ten cases can be reduced if treated early.

Causes

Diabetic retinopathy is a condition where blood vessels of the retina are damaged.  There are two types of the condition. 

  • Non-proliferative diabetic retinopathy develops as blood vessels in the eye get enlarged in a condition called microaneurysms.  They can also be blocked with small amounts of hemorrhaging and leakage into the retinal which leads to vision problems.

Proliferative diabetic retinopathy (PDR) is more severe where new but more fragile blood vessels grow in the eye and bleed or hemorrhage to produce small scars on the retina and the vitreous parts of the eyes with resulting loss of vision.

Signs and Symptoms

There are no warning signs from the condition. Severe non-proliferative diabetic retinopathy progresses into a more advanced proliferative stage when blood vessels grow.  In most cases of PDR where there is ocular hemorrhage, vision is blurred.  The first bleeding may not be severe, leaving only visual spots, floaters and shadowy images in your visual field which can disappear in a few hours. Night blindness or difficulty in seeing at night is also common,  In a few days or weeks, the retina can experience greater blood vessel hemorrhaging to result in more severe blurring.  In the worst cases, sufferers can only distinguish between light and dark in the affected eye. It can take the blood from a few days to months or even years to clear.  These large hemorrhages often take place during sleep.

Risk Factors

Anyone with diabetes mellitus under Type I (juvenile onset) and type II (adult onset) are at high risk to the condition. The longer the person has suffered diabetes the higher the risk of an ocular problem. 40% to 45% of Americans with diabetes have diabetic retinopathy in varying degrees.  After 20 years, nearly all diabetics with Type I and more than 60% with Type II have the condition in differing levels.

Managing the Condition

The best way to deal with early stages of diabetic retinopathy is constant vigilance through monitoring of your condition. Controlling or correcting blood sugar, cholesterol and blood pressure levels as well as avoiding tobacco products can go a long way to a therapeutic management and prevention of the condition.

There are there major treatments considered quite effective in minimizing vision loss.  Its application in advances stages of the condition has also achieved a 90% chance of success in preventing severe damage to the retina. 

  • Intravitreal triamcinolone acetonide is a steroid preparation injected in the vitreous cavity of the eyeball to reduce the macular edema or thickening of the retina at the central areas which typically happens with diabetic conditions.  The drug can also increase visual acuity in some patients.  Regular injections are needed to maintain its efficacies since the benefits of each injection only last up to three months at the most.  There are just a few side effects from the drug like endophthalmus, cataract and steroid-induced glaucoma.
  • Panretinal photocoagulation (PRP) or scatter laser treatment treats proliferative diabetic retinopathy which creates up to 2,000 burns in the retina to starve its oxygen demand and destroy abnormal blood vessels forming in the retina.  This procedure has proven to reduce the risk of severe vision loss by 50%
  • As an alternative to laser surgery, vitrectomy is performed where are numerous blood clots in the vitreous section of the eyeball.  The procedures involved replacing the debris laden vitreous with saline solution. People who have undergone the process after a significant hemorrhaging has a greater likelihood of protecting their vision that those who take their time.  People with insulin-dependent diabetes benefits from early vitrectomy since they have greater risks of blindness due to condition.

Other Treatment Options

Since 2008, there have been medical developments that treat the condition.  Drugs like anti-vascular endothelial growth factor (VEGF) and kinase inhibitors have become available.  In addition, there are experimental therapies that show promise but are still far from commercial availability.  One is c-peptide, a byproduct of insulin production that treats diabetic complications relating to the condition. Pine bark extracts of oligomeric proanthocyanidins have shown promise in improving microcirculation, and visual acuity in retinal retinopathy.