Diabetic retinopathy
(die-uh-BET-ik ret-ih-NOP-uh-thee) is a diabetes complication that affects
eyes. It's caused by damage to the blood vessels of the light-sensitive tissue
at the back of the eye (retina).
At first, diabetic
retinopathy may cause no symptoms or only mild vision problems. Eventually, it
can cause blindness.
The condition can
develop in anyone who has type 1 or type 2 diabetes. The longer you have
diabetes and the less controlled your blood sugar is, the more likely you are
to develop this eye complication.
Symptoms
You might not have
symptoms in the early stages of diabetic retinopathy. As the condition
progresses, diabetic retinopathy symptoms may include:
·
Spots or dark strings floating in your vision (floaters)
·
Blurred vision
·
Fluctuating vision
·
Impaired color vision
·
Dark or empty areas in your vision
·
Vision loss
Diabetic retinopathy
usually affects both eyes.
When to see a doctor
Careful management of
your diabetes is the best way to prevent vision loss. If you have diabetes, see
your eye doctor for a yearly eye exam with dilation — even if your vision seems
fine. Pregnancy may worsen diabetic retinopathy, so if you're pregnant, your
eye doctor may recommend additional eye exams throughout your pregnancy.
Contact your eye doctor
right away if your vision changes suddenly or becomes blurry, spotty or hazy.
Causes
Over
time, too much sugar in your blood can lead to the blockage of the tiny blood
vessels that nourish the retina, cutting off its blood supply. As a result, the
eye attempts to grow new blood vessels. But these new blood vessels don't
develop properly and can leak easily.
Risk factors
Anyone who has
diabetes can develop diabetic retinopathy. Risk of developing the eye condition
can increase as a result of:
·
Duration of diabetes — the longer you have diabetes, the greater
your risk of developing diabetic retinopathy
·
Poor control of your blood sugar level
·
High blood pressure
·
High cholesterol
·
Pregnancy
·
Tobacco use
·
Being African-American, Hispanic or Native American
Complications
Diabetic retinopathy
involves the abnormal growth of blood vessels in the retina. Complications can
lead to serious vision problems:
·
Vitreous hemorrhage. The new blood vessels may bleed into the clear, jelly-like
substance that fills the center of your eye. If the amount of bleeding is
small, you might see only a few dark spots (floaters). In more-severe cases,
blood can fill the vitreous cavity and completely block your vision.
Vitreous hemorrhage by itself usually doesn't cause permanent
vision loss. The blood often clears from the eye within a few weeks or months.
Unless your retina is damaged, your vision may return to its previous clarity.
·
Retinal detachment. The abnormal blood vessels associated with diabetic
retinopathy stimulate the growth of scar tissue, which can pull the retina away
from the back of the eye. This may cause spots floating in your vision, flashes
of light or severe vision loss.
·
Glaucoma. New
blood vessels may grow in the front part of your eye and interfere with the
normal flow of fluid out of the eye, causing pressure in the eye to build up
(glaucoma). This pressure can damage the nerve that carries images from your
eye to your brain (optic nerve).
·
Blindness. Eventually,
diabetic retinopathy, glaucoma or both can lead to complete vision loss.
Diagnosis
Diabetic retinopathy
is best diagnosed with a comprehensive dilated eye exam. For this exam, drops
placed in your eyes widen (dilate) your pupils to allow your doctor to better
view inside your eyes. The drops may cause your close vision to blur until they
wear off, several hours later.
During the exam, your
eye doctor will look for:
·
Abnormal blood vessels
·
Swelling, blood or fatty deposits in the retina
·
Growth of new blood vessels and scar tissue
·
Bleeding in the clear, jelly-like substance that fills the
center of the eye (vitreous)
·
Retinal detachment
·
Abnormalities in your optic nerve
In addition, your eye
doctor may:
·
Test your vision
·
Measure your eye pressure to test for glaucoma
·
Look for evidence of cataracts
Fluorescein angiography
With your eyes dilated, your doctor takes pictures of the inside
of your eyes. Then your doctor will inject a special dye into your arm vein and
take more pictures as the dye circulates through your eyes' blood vessels. Your
doctor can use the images to pinpoint blood vessels that are closed, broken
down or leaking fluid.
Treatment
Treatment, which depends largely on the type of diabetic
retinopathy you have and how severe it is, is geared to slowing or stopping
progression of the condition.
Even after treatment
for diabetic retinopathy, you'll need regular eye exams. At some point,
additional treatment may be recommended.