Advanced Diabetic Retinopathy

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

2. 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.

Remember

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”