Eye Disease: Diabetic Retinopathy

Diabetic retinopathy is a complication of diabetes and a leading cause of blindness. It occurs when diabetes damages the tiny blood vessels inside the retina in the back of the eye. A healthy retina is necessary for good vision.

All people with diabetes -- both type 1 and type 2 -- are at risk for diabetic retinopathy. That's why everyone with diabetes should get a comprehensive dilated eye exam at least once a year.

Conflicting findings are observed in different studies:

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  Some studies show that diabetic retinopathy was not any more prevalent among the Latino Community. However, because diabetes is more prevalent, more Latinos, overall, have diabetic retinopathy. Other studies found that there was a higher frequency of severe diabetic retinopathy among Hispanics.

• Another study showed that half of the participants (all Hispanic) who all had diabetes, also had some form of diabetic retinopathy. In this study, it was also found that Latinos appear to have a higher rate of "more severe vision-threatening" diabetic retinopathy than non-Hispanic whites.

The four stages of diabetic retinopathy are:

1. mild nonproliferative retinopathy
2. moderate nonproliferative retinopathy
3. severe nonproliferative retinopathy
4. proliferative retinopathy

1. Mild nonproliferative retinopathy:

At this earliest stage, there are small areas of balloon-like swelling in the retina's tiny blood vessels.

2. Moderate nonproliferative retinopathy:

As the disease progresses, some blood vessels that nourish the retina are blocked.

3. Severe nonproliferative retinopathy:

Many more blood vessels are blocked, depriving several areas of the retina of their blood supply. These areas send signals to the body to grow new blood vessels for nourishment.

4. Proliferative retinopathy:

At this advanced stage, the signals sent by the retina for nourishment cause the growth of new blood vessels. These new blood vessels are abnormal and fragile.

The new blood vessels grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye. By themselves, these blood vessels do not cause symptoms or vision loss. However, they have thin, fragile walls. If they leak blood, severe vision loss and even blindness can result.

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PREVENTION

Diabetic retinopathy often has no early warning signs. It cannot be totally prevented, but the risks can be greatly reduced.

Don't wait for symptoms. Be sure to have a comprehensive dilated eye exam at least once a year to detect the disease before it causes damage to your vision.

To prevent progression of diabetic retinopathy, studies show that people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol.

DETECTION / SYMPTOMS

When bleeding occurs, it causes a few specks of blood, or spots, floating in your vision (hemorrhaging). Below are two pictures; one is viewed under "normal vision" and the other one is viewed under "diabetic retinopathy vision".

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If this occurs, see an eye care professional immediately.

TREATMENT

During the first three stages of diabetic retinopathy, no treatment is needed, unless you have macular edema.

Proliferative retinopathy is treated with laser surgery. This procedure is called scatter laser treatment. Scatter laser treatment helps to shrink the abnormal blood vessels where 1,000 to 2,000 laser burns in the areas of the retina. This usually takes two or three visits to the doctor. Loss of side vision and loss of some color may occur, but the rest of the sight can be saved.

If the bleeding is severe, you may need a surgical procedure called a vitrectomy. During a vitrectomy, blood is removed from the center of your eye.