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Advanced Diabetic Retinopathy

HomeDiabetic Retinopathy

Advanced Diabetic Retinopathy

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Advanced Diabetic Retinopathy

Diabetic Retinopathy


The eye is like a camera and the inner lining of the back of the eye is called retina which corresponds to the film of the camera. High blood sugar in Diabetic patients affect the retina and is called diabetic retinopathy diabetic retinopathy is one of the leading causes of severe vision loss in both the Western world as well as in India loss of vision caused by this complication is preventable provided it is detected and treated in time


What happens in diabetic retinopathy?


In diabetes there is a damage to the blood vessels of the retina and as a result there may be a leak in fluid proteins or fats or they may rupture and cause hemorrhage that is bleeding and may also cause blockage ,this is seen in non-proliferative diabetic retinopathy (NPDR) which progresses from mild, moderate to severe retinopathy in few years and may not cause any symptoms in the earlier stage of the disease


ln the advanced stage which is called Proliferative diabetic retinopathy that is PDR the blood vessels of the retina gets blocked and subsequent loss of nutrition and oxygen to the retina promote the growth of new fragile abnormal vessels on the optic disc and elsewhere. These new fragile vessels easily rupture and cause large hemorrhages and sudden severe loss of vision and blindness


When there is a swelling in the central part of the retina called Macula, it results in difficulty in near vision and is called Diabetic macular edema which requires early treatment

Detection and Prevention of vision loss


The problem with diabetic retinopathy is that there are no symptoms in early stages in packed more than 50% of the patients with advanced retinopathy may have good vision for five years or more by the time vision loss occurs it is open late consider the following steps to avoid vision loss


1) Routine eye examination


Early detection and treatment can prevent visual impairment . Remember retinopathy often has no symptoms. People with diabetes should have at least yearly eye examination. More frequent check-ups may be required in severely affected patients as suggested by your doctor


2 ) Diabetes Control


Good blood sugar control helps to prevent or may postpone the appearance of retinopathy However retinopathy may be present in spite of good control. Poorer the control the more the risk of having retinopathy and greater the severity.


3) Control of Blood pressure and high cholesterol


High blood pressure and cholesterol accelerates the development and severity of diabetic retinopathy and increase the chances of bleeding in the eye. Control of blood pressure and high cholesterol is essential and it must be treated and controlled.


4) Stop smoking and alcohol intake


 Smoking or drinking alcohol increases the risk of diabetic retinopathy


5) Regular moderate physical activity or exercise or walking is beneficial


Treatment of Diabetic Retinopathy


1) Laser treatment


Although laser is not a cure for vision loss, it helps to maintain the existing vision and prevent blindness in many diabetics. By doing laser we can prevent the complications of retinopathy such as vitreous hemorrhage, fibrous scar formation and retinal detachment. The major aim of laser therapy is to restore/ maintain vision and to prevent blindness.


Laser treatment can be done in one, two or three sittings depending upon the severity of diabetic retinopathy.


2) Intravitreal injections

 there are many different injections available which have been shown to be beneficial in reducing swelling in the macula to improve or stabilise vision in patients of diabetic retinopathy.


These are

  1. Anti-VEGF injection Avastin, Zaltrap, Accentrix, Eyelea
  1. Intraocular Steroids/Implants Ozurdex, IVTA


Injections work well alone or sometimes in combination with laser. Your doctor will be the best judge of which injection will be most beneficial for you.


The effect of each of these injections last for 1-3 months and you might need multiple injections if the swelling keeps recurring. The best way to prevent swelling from coming back is to keep strict control of blood sugar.


Intraocular injections are the mainstay of treatment in swelling in the centre of retina i.e  Diabetic macular edema.


3) Surgical Treatment


Surgical treatment of diabetic retinopathy or Vitrectomy is required in advanced stages like if the patient develops vitreous hemorrhage or bleeding inside the eye or there is a retinal detachment or severe scarring or fibrous tissue formation leading to severe visual loss. Visual prognosis in such advanced cases is usually guarded.




Diabetic retinopathy is a disease which affects most people with diabetes mellitus. Loss of vision caused by this complication is preventable provided it is detected and treated on time. Periodic eye examinations are vital for all diabetics. The amount of vision which has already been lost as a result of retinopathy can sometimes be restored. Hence the early treatment of retinopathy is advisable.


Once vision loss occurs it may be irreversible.

Remember –  “Prevention is better than cure”

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+91 99203 92108
+91 93246 36580

Dr. Kamlesh Gupta

MBBS, MD - Ophthalmology Ophthalmologist/ Eye Surgeon 20 Years Experience Overall (13 years as specialist)

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Moreshwar Shantinagar CHS Ltd,Sector No.1 Opp. TMT Bus Stop
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Mira Road, Thane,
Maharashtra 401107

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