Eye Exams for Diabetic Eye Disease, Problems & Retinopathy
Diabetes is a disease of the small blood vessels throughout the body. When diabetes damages these small blood vessels it will impair the normal circulation of blood in certain organs and tissues. It is common for patients with diabetes to suffer from difficulty with the circulation in their kidneys, nerves and eyes—especially the very small blood vessels of the eye found in the retina. When diabetes causes damage to the small blood vessels in the retina, it is called Diabetic Retinopathy. Diabetic Retinopathy is categorized in stages, as follows:
Mild Nonproliferative Retinopathy
Mild Nonproliferative Retinopathy is the earliest stage of Diabetic Retinopathy. It is characterized by the presence of “dot” and “blot” hemorrhages and “microaneurysms” in the Retina during your eye examination. Microaneurysms are areas of balloon like swelling of the tiny blood vessels in the Retina caused by the weakening of their structure. Mild Nonproliferative Retinopathy can be present without any change in your vision. Mild Nonproliferative Retinopathy usually does not require treatment unless it progresses or if it is accompanied by Diabetic Macular Edema. If you have Mild Nonproliferative Retinopathy, your doctor will make specific recommendations about how often you will need to be reexamined.
Moderate Nonproliferative Retinopathy
Moderate Nonproliferative Retinopathy is slightly more severe stage where some of the small blood vessels in the retina may become blocked causing a decrease in the supply of nutrients and oxygen to certain areas of the Retina. The best way to diagnose blockage of the small blood vessels in the retina is by having a diagnostic test called an Intravenous Fluorescein Angiogram (IVF).
Severe Nonproliferative Retinopathy
Severe Nonproliferative Retinopathy is characterized by many of small blood vessels in the retina becoming blocked, depriving it of nourishment and oxygen resulting in a condition “Retinal Ischemia” which can lead to the growth of new fragile retinal blood vessels called neovascularization.
Proliferative Retinopathy
Proliferative Retinopathy is characterized by the growth of abnormal blood vessels. They grow in an attempt to supply the retina with the nutrition it needs to function. Unfortunately, the new vessels grow in the wrong direction and cause more harm. They tend to break easily and hemorrhage into the Vitreous leading to scarring and ultimately to retinal detachment with profound vision loss, even blindness.
Diabetic Macular Edema
Diabetic Macular Edema is a common complication of diabetic eye disease and may occur at any stage of Diabetic Retinopathy (DR). DR damages the small blood vessels in the retina so that they become porous, resulting in fluid leakage and swelling of the Macula. This swelling is a condition called Diabetic Macular Edema.
The most effective and accurate ways to observe and diagnose Diabetic Macular Edema are to perform Optical Coherence Tomography (OCT) and Intravenous Fluorescein Angiography (IVF). It is possible to have Diabetic Macular Edema and not have vision loss. Dr. Kelly will review the results of your testing with you and make recommendations as to whether laser photocoagulation or perhaps Vascular Endothelial Growth Factor (VEGF) Inhibitor injections offer the best course of treatment to prevent vision loss. Today, for most patients, VEGF inhibitor intravitreal injections, which are less destructive and safer than laser treatments, are considered as primary therapy for the management of vision-threatening complications of diabetic retinopathy such as diabetic macular edema (DME).
Diabetic Retinopathy Treatment with Injections & Laser
Treatment of diabetic retinopathy can entail the use retinal laser photocoagulation treatment and/or intravitreal injections of Vascular Endothelial Growth Factor (VEGF) Inhibitor drugs or other drugs. However, successful management of diabetic eye problems requires early diagnosis and treatment.
Dr. Kelly will review the results of your testing with you and make recommendations as to whether laser photocoagulation or perhaps Vascular Endothelial Growth Factor (VEGF) Inhibitor injections offer the best course of treatment to prevent vision loss. Today, for most patients, VEGF inhibitor intravitreal injections such as Avastin®, Vabysmo®, Beovu®, Lucentis® or Eylea®, which are less destructive and safer than laser treatments, are considered as primary therapy for the management of vision-threatening complications of diabetic retinopathy such as diabetic macular edema (DME).
The National Institutes of Health and the National Eye Institute have funded a number of large scale, multi-center, controlled studies that have produced clinical care guidelines for Diabetic Retinopathy used by our physicians. These include:
Dr. Kelly uses the results of these studies to guide patients in the treatment of diabetic retinopathy since with early treatment it is possible for patients with diabetic retinopathy to have only half the likelihood of losing vision as compared to those patients who fail to receive early treatment.
However, to prevent the progression of diabetic retinopathy it is quite important to maintain good overall health. First, rigid control of blood sugar levels is a key for protecting the health of the small blood vessels. Patients should work to reduce any and all risk factors for vascular disease including controlling their blood pressure, not smoking, reducing dietary fat consumption to lower cholesterol and triglycerides and exercising regularly.
If you have been diagnosed with diabetic eye disease including diabetic retinopathy or diabetic macular edema you may require treatment with laser photocoagulation and/or injections of Lucentis® or Eylea® to reduce the risk of vision loss. Please call Center for Sight in Fall River, Massachusetts at 508-730-2020.
