Diabetes is an ever-increasing epidemic in America, and our eyes are one of the first places that the deleterious effects of diabetes can be detected. It is for this reason that your primary care doctor encourages you to see an eye physician for regular examinations.
Diabetic retinopathy is a spectrum of eye disorders that are seen in patients with diabetes. Both insulin-dependent and non-insulin-dependent diabetes can lead to diabetic retinopathy. In general, the poorer your blood sugar control and the longer you have had diabetes, the higher your risk of developing retinopathy. It is important to remember that the presence of diabetic retinopathy corresponds to your likelihood of developing diabetic problems in other organs, such as your kidneys, heart and nerves.
Nonproliferative diabetic retinopathy (NPDR) is the most common type of diabetic retinopathy. One of the main targets of diabetes in our bodies is our blood vessels. Diabetes causes changes in our blood vessels that prevent oxygen from being properly distributed to our organs. The blood vessels of the eyes are no exception. Changes that can be seen include microscopic bulges (aneurysms) in the vessels, leakage of blood into the retina, and swelling in the retina. Nonproliferative diabetic retinopathy is graded as mild, moderate or severe, based on the severity of these changes seen on examination.
Proliferative diabetic retinopathy
Proliferative diabetic retinopathy (PDR) is a more advanced form of this disease process. In PDR, new, abnormal blood vessels form in the retina in response to the retina’s poor oxygen supply. The problem is that the new blood vessels are very weak; they are prone to break and spill blood into the retina and vitreous. Left untreated, they form bands of scar tissue and can pull the retina away from the eye. This is called a tractional retinal detachment and it is very difficult to treat. Therefore, great effort should be taken to treat PDR as soon as it is discovered. This often involves laser treatments for the retina that are performed by a retina specialist. In recent years, various medications have become available that can be injected directly into the eye. The goal of these injections is to induce regression of the abnormal blood vessels before they cause irreparable damage.