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+ Larger Font / - Smaller Font Diabetic Retinopathy The American Diabetes Association estimates that approximately 18.2 million people, 6.3 percent of the population, have diabetes. Diabetic complications are the leading cause of irreversible blindness in patients under 65 and is now responsible for anywhere from 12,000 to 24,000 new cases of blindness each year. For diabetics over the age of 40, one in every twelve will develop diabetic retinopathy. The National Diabetes Information Clearinghouse (NDIC) found in their study conducted from 1983-1993 that maintaining blood sugars close to normal can significantly slow the progression of retina, kidney, and nerve diseases. There are two forms of diabetic retinopathy: background and proliferative Background diabetes retinopathy is manifested by early retinal hemorrhages and possibly edema which significantly affects vision. Proliferative diabetes retinopathy occurs because of ischemia (abnormal reduction of blood supply) of the retina. The ischemia causes a serge of Vascular Endothelial Growth Factor (VEGF) which produces new, defective blood vessel growth. These new, defective blood vessels can leak and cause vitreous hemorrhage. The new vessels can also cause scarring which prevents tissue growth. The scar tissue can shrink, wrinkle and pull on the retina causing it to detach. Symptoms  Patients with background diabetic retinopathy may not have any symptoms initially. That is why it is so important to encourage regular ophthalmic visits for this population. This is a preventable disease if caught early. When edema, scarring, and hemorrhages occur, the patient will experience vision loss. Symptoms widely depend on the stage of the disease. Patients may complain of blurred vision floaters and flashes and sudden loss of vision. Risk Factors  Gestational diabetes American Indians/Alaska Natives are at most risk for diabetes Obesity Treatments Lifestyle changes: The most important treatment is maintaining good diabetic control through a careful diet and exercise program, losing excess weight, and taking medication as prescribed. Good control of cholesterol and blood pressure. Other treatments your physician my prescribe: Panretinal photocoagulation (PRP): A laser is directed to the damaged retina. When the laser hits the blood or pigment in the retina, it is absorbed as heat energy and produces many small burns on the edges of the retina. The burns produce small scars. This method is believed to reduce the production of insufficient blood vessels. Surgery: Sometimes surgery is indicated to remove hemorrhages in the vitreous and repair a detached retina. The overall goal for diabetic retinopathy is to stablilize the vision and prevent further vision loss. Future Treatments: Because our aging population is growing, there is a renewed interest in advancing retina treatments. Those treatments are outlined below: Anti VEGF treatments: Medication is injected into the vitreous approximately every 6 weeks. Names of the medications included in this category: Macugen, Lucintis and Retaane. Additional information regarding VEGF: When pigment epithelium becomes stressed, it sends out a distress signal. This signal results in the body increasing VEGF, which stimulates the growth of defective vessels. These medications stop this process. Retina Microchips: These microchips can be implanted in the back of the eye to function as an artifical retina. Stem Cell Transplantation: Stem cell is a promising option to cure retina diseases repopulating the diseased tissue. Special thanks to National Eye Institute, National Institutes of Health Other Suggested Links: American Diabetes Association American Academy of Ophthalmology American Foundation for the Blind American Optometric Association EyeCare America Prevent Blindness America West Texas Retina Consultants Sunil S. Patel, M.D., Ph.D. S. Young Lee, M.D. 5441 Health Center Dr. Abilene, Texas 79606 800-810-7411 325-673-9806 info@westtexasretina.com |
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