Treatment of diabetic retinopathy

Treatment of diabetic retinopathy

 

Patients with diabetes often face complications in various parts of the body, such as heart disease, kidney failure, numbness in the limbs, chronic wounds, and notably, diabetic retinopathy, which is one of the leading causes of vision loss in the country.

 

Why does diabetes affect the retina ?

 

Diabetic retinopathy occurs when the blood sugar levels of diabetes patients become abnormally high, leading to side effects on the retina. This condition can develop in 30-40% of diabetes patients. Those at higher risk include individuals who have had diabetes for a long time without regular screening for diabetic retinopathy, as well as those with high blood sugar, high blood pressure, or high cholesterol levels. Changes occur in the capillaries throughout the body, including alterations in the blood vessel walls of the retina.

 

Symptoms of diabetic retinopathy and their risks

 

In the early stages, diabetic retinopathy may not show significant symptoms, making it difficult for patients to realize they have the condition. However, if left untreated, proteins, blood cells, lymphatic fluid, and fats can accumulate in the retina, leading to visual disturbances, blurry vision, and retinal swelling (diabetic macular edema). Prolonged untreated conditions can result in new blood vessel growth (neovascularization), bleeding, cloudy vitreous humor, retinal detachment, and ultimately blindness.

 

Prevention of diabetic retinopathy

 

The best prevention strategy for diabetic patients is to maintain blood sugar levels below 110 mg/dL. For patients with other underlying conditions like high blood pressure, it’s important to control blood pressure to normal levels (below 140/90 mmHg). Regular healthy eating, consistent exercise, and annual eye check-ups are crucial. Patients should immediately consult an ophthalmologist if they experience blurry vision, see floating black spots, or notice flashes of light. Adhering to treatment plans and follow-up appointments is essential.

 

Laser treatment for diabetic retinopathy

 

Panretinal laser photocoagulation is a treatment option that involves using laser light to close leaking blood vessels in the retina. This method can cause abnormal blood vessels to shrink, reducing retinal swelling and preventing further bleeding, thus improving vision clarity. Side effects may include narrowed visual fields and reduced night vision, but the benefits generally outweigh these risks. The laser procedure is straightforward.

 

The laser treatment helps to slow or stop leakage of fluids, constrict abnormal blood vessels, and reduce retinal swelling. Patients receive dilating and anesthetic eye drops prior to the procedure to minimize discomfort. After treatment, patients can return home without special care and may wash their faces as usual.

 

 

Ongoing care for patients with diabetic retinopathy

 

All diabetes patients should see an ophthalmologist annually to assess for diabetic retinopathy, even if no unusual symptoms are present. In addition to laser treatment, doctors may manage less severe cases by controlling diabetes and blood sugar levels, as this is the easiest treatment phase. For those at risk of blindness, injections into the eye have become a standard treatment method. This approach rapidly reduces swelling in the affected area, leading to quicker recovery of vision. Surgical options may be necessary in cases of chronic vitreous hemorrhage, retinal membrane formation, or retinal detachment.

 

 

 

 

source : PHAYATHAI Phaholyothin Hospital