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    Diabetic Retinopathy: From Diagnosis to Treatment
    Diabetic Retinopathy: From Diagnosis to Treatment
    Diabetic Retinopathy: From Diagnosis to Treatment
    Ebook145 pages1 hour

    Diabetic Retinopathy: From Diagnosis to Treatment

    By David S. Boyer and Homayoun Tabandeh

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    About this ebook

    The most common eye disease among those with type 1 or type 2 diabetes is diabetic retinopathy and this book explains the disease, how it develops, and options for treatment. Affecting more than five million Americans, the disease is caused by damage to the tiny blood vessels of the retina as the result of uncontrolled blood sugars, and is a leading cause of blindness. Diabetic retinopathy cannot be cured, however the onset can be delayed and the risk of progression can be reduced by keeping tight controls on glucose levels and making the right lifestyle choices. This guide will help both patients and their families by covering such topics as symptoms, stages of the disease, how it is diagnosed, treatment options, ways to slow its progression, and lifestyle changes that lead to better glucose control.

    LanguageEnglish
    PublisherIndependent Publishers Group
    Release dateMar 1, 2014
    ISBN9781936374465
    Diabetic Retinopathy: From Diagnosis to Treatment

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      Book preview

      Diabetic Retinopathy - David S. Boyer

      project.

      Introduction

      Diabetes can affect the eye in many different ways. The most serious and common eye complication of diabetes is diabetic retinopathy. Diabetic retinopathy is the leading cause of vision loss in the working-age population. The American Diabetes Association estimates that 12,000 to 24,000 individuals with diabetes lose their eyesight each year due to the disease. Caused by changes in the blood vessels of the retina, diabetic retinopathy is a potential problem for people with either type 1 or type 2 diabetes. Without proper diagnosis and treatment it can do irreversible damage to your eyesight, sometimes before you even notice.

      As retina specialists, we diagnose and treat patients with diabetic retinopathy every day. The number of individuals suffering vision problems associated with this eye condition is rising, not surprising given the epidemic increase in diabetes, its underlying cause.

      If you or someone you know has been diagnosed with diabetic retinopathy, you will likely have many questions, both about the disease and the hurdles that may be encountered in the future. This book is a comprehensive, yet concise and easy-to-read, overview of both nonproliferative and proliferative diabetic retinopathy, the two major forms of this disease. We explore the causes, symptoms, and current treatments. Although no cure exists for diabetic retinopathy, today’s therapies offer hope to millions of patients. Your eye specialist cannot reverse the damage that has already occurred, but he or she can help preserve your remaining vision.

      It is our hope that this book will help you understand diabetic retinopathy and reduce the risk of damage to your vision.

      If you have type 1 or type 2 diabetes, you are at risk for developing diabetic retinopathy. According to the National Eye Institute, between 40 and 45 percent of Americans with diabetes have some form of diabetic retinopathy, the most common eye condition linked to diabetes.

      In the United States, the Centers for Disease Control and Prevention reports between 12,000 and 24,000 new cases of blindness each year due to diabetic retinopathy, making it the leading cause of vision loss among American adults between the ages of twenty and seventy-four. The Center also projects that by 2050, the number of Americans ages forty and older affected by diabetic retinopathy will grow from a current 5 million individuals to about 16 million. Although these statistics are alarming, you can prevent or delay damage to your vision by controlling your diabetes along with getting regular eye evaluations and treatment.

      Defining Diabetic Retinopathy

      Diabetic retinopathy is a disease of the retina caused by diabetes. It usually affects both eyes and occurs when uncontrolled blood sugar levels damage the small vessels of the retina, the light-sensitive tissue in the back of your eye. The retina is responsible for processing images that make vision possible. To produce clear, distortion-free vision, the retina must receive an abundant supply of oxygen and nutrients. If the blood vessels to the retina are damaged as a result of diabetes, the retina becomes deprived of essential nutrients and will not function correctly. The delicate retina tissue is gradually damaged, and images that you see may be blurred or otherwise distorted.

      Eye Anatomy

      Diabetic retinopathy is a progressive disease—it worsens over time. Although some effects, such as blurriness and distortion, may be mild or short-term, other complications can cause severe, long-term vision loss.

      Symptoms of Diabetic Retinopathy

      Because diabetic retinopathy rarely causes pain, symptoms are not always apparent in the early stages. In fact, damage to your retina could be occurring long before you have noticeable signs. When symptoms do occur, they are often caused by retinopathy affecting the macula, the area of the retina responsible for central vision. Symptoms may include the following:

      blurred vision

      seeing dark spots or floaters (small specs in your field of vision)

      vision loss

      blind spots in your vision

      It is important that you see your eye specialist as soon as possible if you have any such symptoms. Diabetic retinopathy cannot be cured, but with careful monitoring it can be diagnosed, treated, and controlled before it impairs your vision further.

      Types of Diabetic Retinopathy

      The main forms of diabetic retinopathy include nonproliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR), diabetic macular edema, and advanced diabetic eye disease.

      Nonproliferative Diabetic Retinopathy

      Nonproliferative diabetic retinopathy is an early form of the disease in which symptoms might be nonexistent or mild. Damage results from injury to the capillaries, small blood vessels of your retina. With nonproliferative diabetic retinopathy, damage to the retina may occur in two ways. First, the tiny vessels weaken, and eventually leak blood and fluid into the retina. Second, blockage of small bloodvessel networks may result in areas of the retina becoming deprived of oxygen and nutrients. This leads to a cycle of more retinal tissue damage and more abnormal leakage from the blood vessels.

      Nonproliferative Diabetic Retinopathy

      This illustration represents retina tissue. Nonproliferative diabetic retinopathy occurs when tiny blood vessels in the retina are damaged as a result of poor blood sugar control. The dark patches represent tiny hemorrhages.

      Eye specialists classify nonproliferative diabetic retinopathy as mild, moderate, or severe depending on the amount of retinal abnormalities they see during a retina examination. These stages of the disease are described in the text that follows.

      Mild nonproliferative diabetic retinopathy. This phase occurs when retinal blood vessels first weaken and leak. Tiny bulges, known as microaneurysms, protrude from the vessel walls. At the same time, retinal hemorrhages, tiny dots or blotches, leak from the capillaries into the retina while protein and lipid deposits, called hard exudates, form on the retina. They look like tiny waxy white or yellow flecks. Although an ophthalmologist can see these flecks during an eye examination, you may not notice any symptoms at this point, unless the center of your macula is involved.

      The Human Eyeball: Similar to a Camera

      The eyeball lens is a focusing system, similar to a camera lens. The retina, tissue lining the back of the eye, functions as the camera’s film. The retina carries signals (images we see) along the optic nerve to the brain, where they are interpreted as vision.

      The macula, the area at the center of the retina, allows you to see fine details and recognize colors. A dimple, known as the fovea, at the center of the macula makes sharp vision possible.

      The peripheral retina, which is the portion of the retina that is outside the macula, is responsible for your side vision. It also makes night vision possible. The space between the retina and the lens, the vitreous, is filled with clear gel that enables the eyeball to hold its shape.

      The retina receives oxygen and nutrients through two different networks of blood vessels—the retinal blood vessels and choroid blood vessels. The choroid is a carpet of blood vessels that nourishes the outside layer of the retina.

      Moderate nonproliferative diabetic retinopathy. This stage of retinopathy occurs as more hemorrhages and microaneurysms form. Small vessels that normally nourish the retina actually may become blocked or closed. These obstructions may cause a decrease in the supply of oxygen and nutrient-rich blood to the retina, particularly to the macula, in what is called retinal or macular ischemia. The oxygen loss prevents the macula from working correctly and causes vision problems.

      Severe nonproliferative diabetic retinopathy. This stage is characterized by more extensive retinal hemorrhages, microaneurysms, dilation of blood vessels, and opening of blood vessels called intraretinal microvascular abnormalities. Because many more retinal blood vessels are blocked or closed during this stage of nonproliferative diabetic retinopathy, larger areas of the retina are deprived of necessary oxygen and nutrients. In an attempt to reestablish the oxygen supply and nourishment, the retina produces special chemicals that trigger growth of new blood vessels. Increased production of these chemicals also causes the retinal blood vessels to leak more and build up fluid in the retina, particularly in the macula.

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