What is Diabetic Retinopathy?
Diabetes can cause changes in all parts of the eye, but most crucially and frequently in the retina of the eye (Retinopathy), and the lens of the eye (cataract). Retinopathy emerges due to the deterioration of the small blood vessels in the retina. They can get lumpy as an old bicycle tube, calcify, and begin leaking. If this state goes untreated for a prolonged period, new vessels start to emerge to solve the issue of lacking nutrition to the retinal layer. However, these new vessels are very fragile, which often leads to large haemorrhages/bleedings in the retinal layers and into the vitreous body.
With type 2 Diabetes, one is especially at risk of developing changes in the macula, which can reduce the visual acuity in the central vision field, e.g. making it harder to read.
With type 1 Diabetes, new and weak blood vessels in the retina can lead to bleeding in the inner eye (in the vitreous body) with a critical loss of vision.
The stages of Diabetic Retinopathy
The four stages of diabetic retinopathy are classified as mild, moderate, and severe non-proliferative and proliferative. Below is an example of mild to moderate diabetic retinopathy with markings on the changes.
Read more about the stages of Diabetic Retinopathy here: https://www.nhs.uk/conditions/diabetic-retinopathy/stages/ and https://www.preventblindness.org/what-are-stages-diabetic-retinopathy
What are the symptoms of Retinopathy?
In the beginning, often nothing is felt or noticed. One can have a case of Diabetic Retinopathy for several years without experiencing any discomfort. However, large amounts of people with diabetes develop sight-threatening eye changes, since the disease/following complication is not discovered in time.
A good control of both blood sugar and blood pressure, along with i.e. laser treatment, can stop the disease from developing and save sight. Therefore, regular check-ups of the eyes are crucial – even when symptoms are not evident.
Late stage Diabetic retinopathy can have the following symptoms:
- Sudden and severe sight impairment, if it is due to bleeding in the inner eye (vitreous body)
- Gradual loss of near field eyesight, caused by swelling in the macula area (DME)
How is the diagnosis made?
The diagnosis is made by examination with a so-called ophthalmoscope (a special instrument that sends light though the pupil) or by photographing the retina (with a fundus camera) after using pupil-dilating drops. An eye specialist can see enlarged photos of the retina and carefully examine, if changes are present.
Only an ophthalmologist can make a diagnosis, therefore, one should have a check-up examination by an eye specialist regularly when getting older. The RetinaLyze system functions solely as a preliminary screening.
How is Diabetic Retinopathy treated?
If the Diabetic Retinopathy is sight impairing to a severe extent, the eyes are laser treated.
If there are large bleedings and tissue formations in the inner eye (vitreous body), a surgery can be necessary in order to remove these, and in some cases, put the retina back in its correct position.
If the sight is blurred due to swelling in the yellow spot/macula area, treatment can be supplemented with injections of adrenocortical hormone or VEGF inhibitors to the vitreous body. The latter is possibly the most promising.