Diabetic Retinopathy
The effects of diabetes on blood vessels in the retina, the tissue which lines the inner eye. Diabetes causes retinal blood vessels to leak and grow abnormally. There are two main stages of diabetic retinopathy:
Non-proliferative
Patients may have normal vision but the damaged retinal vessels leak fluid. Fat and protein particles may leak from the vessels and become deposited in the retina in patches known as retinal exudates. The retinal vessels may bleed into the retina and result in tiny haemorrhages. If any of the leaky fluid accumulates in the central part of the retina, the vision is affected. This condition is called Macular oedema.
Proliferative
Patients grow new abnormal blood vessels which extend over the surface of the retina. These vessels occasionally invade the gelatinous contents of the eye, the vitreous. The proliferating blood vessels frequently break, causing vitreous bleeding that may significantly decrease vision. Fibrous tissue may grow over the new blood vessels and distort vision. Occasionally, the tissue may contract and pull the retina off the inner surface of the eye, causing a tractional retinal detachment.
Who gets diabetic retinopathy?
Both Type 1 (IDDM) and Type 2 (NIDDM) patients develop diabetic retinopathy. It is the leading cause of blindness in patients of 20 to 74 years old.
How do I know if I have diabetic retinopathy?
Patients may develop advanced stages of diabetic retinopathy without being aware that the disease is progressing. Type 1 diabetics should undergo a retinal examination within five years of the diagnosis of their diabetes. Type 2 diabetics should undergo this examination when their diabetes is diagnosed.
Treatment of diabetic retinopathy
The best treatment is prevention. Strict control of blood sugar levels slows the development and progression of diabetic retinopathy. Pre-proliferative and proliferative diabetic retinopathy may be treated with laser photocoagulation. Macular oedema may also be treated with laser therapy.
Facts and Figures
- 10% of all blindness is due to diabetes
- 28% of W.A. diabetic survey had some form of retinopathy.
- There are 250,000 diabetics in Australia, with an estimated of 225,000 undiagnosed.
- Urban aboriginals have a diabetic incidence of 11% -17%
- High incidence of diabetes in Maori, Tongan, Maltese, Indian and Sri Lankan people.
