What is diabetic retinopathy?

• A potentially blinding retinal condition that can affect individuals with diabetes, including women who develop gestational diabetes
• It can damage the blood vessels in the retina which can lead to temporary vision impairment and if left untreated can lead to retinal detachment and blindness
• Diabetic retinopathy has several subtypes and various treatment options, making it a complex and critical aspect of diabetes management

Sub-types of Diabetic Retinopathy:

1. Non-Proliferative Diabetic Retinopathy (NPDR)
   • An early stage of diabetic retinopathy
   • Characterized by the weakening of blood vessels in the retina, causing them to leak fluid and small amounts of blood into the retina
   • Symptoms may be mild or absent at this stage, but it requires careful monitoring
2. Proliferative Diabetic Retinopathy (PDR)
   • An advanced stage of diabetic retinopathy
   • It occurs when retinal blood vessels become damaged, leading to the growth of new, fragile blood vessels. These new vessels are prone to leakage, causing significant visual problems
3. Diabetic Macular Oedema (DMO)
   • A specific complication of diabetic retinopathy that affects the macula, the central part of the retina responsible for sharp vision
   • Fluid accumulates in the macula, causing it to swell and distort vision
   • DMO can occur at any stage of diabetic retinopathy

What causes diabetic retinopathy?

• It occurs as a result of prolonged high blood sugar levels
• The chance of developing diabetic retinopathy becomes greater the longer you have had diabetes

What are the symptoms?

• There may be no symptoms in the early stages of diabetic retinopathy
• Dark floating spots or streaks in vision
• Blurred or fluctuating vision
• Dark or empty areas in your vision

What is the treatment?

• Treatment for early stages includes:
  • Prevention via well controlled blood sugar levels, blood pressure and cholesterol levels
  • Regular eye examinations as early detection allows for timely intervention and reduces the risk of vision loss
  • Lifestyle and diet changes (balanced diet, regular exercise, weight management)
  • Avoid smoking and excessive alcohol consumption
• Treatment for later stages includes:
  • Laser treatment (Photocoagulation/PRP) is often used to treat PDR and DMO to reduce macular swelling and shrink abnormal blood vessels, preventing them from bleeding and causing damage
  • Intravitreal anti-VEGF eye injections for individuals with DMO or severe NPDR to help reduce the swelling at the retina
  • Retinal surgery is at times needed in advanced and severe cases of PDR where there is significant bleeding and scar tissue
  • Emerging technologies, such as artificial retinas or retinal implants, are being developed to restore vision in individuals who have lost their sight due to diabetic retinopathy. These devices can bypass damaged retinal cells and transmit visual information directly to the brain