Diabetic Retinopathy

Diabetic retinopathy is an eye disease that weakens or changes the blood vessels in the retina of diabetic patients, impairing vision. This is the leading cause of blindness in American adults. Early detection and frequent exams (at least once per year) are best ways to prevent vision impairment in diabetic patients. Call Vistar today for a comprehensive assessment and preventative planning.

Symptoms

Dangerous changes in the retina often happen before patients notice changes in their sight. In many cases, there are no symptoms until the disease becomes severe and vision is blurred or blocked entirely. Because this disease may progress without symptoms, regular eye exams are extremely important for diabetic patients.

Diabetic Retinopathy

Diagnosing

Vistar doctors use all currently available techniques to diagnose diabetic retinopathy, including Ocular Coherence Tomography, Fundus Autofluoresence, A-Scan and B-Scan Ultrasonography, and Fluorescein Angiography. Most importantly, the retina specialists at Vistar Eye Center have extensive training and experience in diagnosing diabetic retinopathy, beyond that of general ophthalmology training.

Stages and Types

Early Stage (Nonproliferative Diabetic Retinopathy)

The Early Stage is indicated by blood vessel changes and fluid build-up without the growth of unhealthy blood vessels.

  • Blood vessels swell and sometimes bulge or balloon (aneurysm).
  • Macular Edema: vessels may leak fluid that can build up in the retina and cause swelling, resulting in vision changes.
  • Occurs when fluid building up in the retina causes swelling and affects vision.
  • May cause blurriness comparable to looking through water.
  • Fluid build-up may clear up on its own, but fatty deposits sometimes remain that can continue to affect vision.
  • Vessels may begin to bleed inside the retina.

Advanced Stage (Proliferative Diabetic Retinopathy)

The Advanced Stage leads to the breakdown of retinal blood vessels leading to (neovascularization) the growth of new, unhealthy blood vessels.

  • Closed small blood vessels are replaced with unhealthy blood vessels.
  • These can grow on the back of the vitreous (the clear gel that fills the eyeball).
  • Vessels may bleed, causing:
  • Dark spots (floaters)
  • Cobweb-like strands
  • Clouded vision
  • As vessels heal, scar tissue may grow causing:
  • Retina to pull away from the back of the eye
  • Torn or detached retina
  • Serious loss of sight or blindness

Treatment

Vistar retina specialists use a number of injection medications to treat retinal complications of diabetes, when appropriate. Patients suffering from diabetic macular edema (DME) can be treated with Lucentis or Eylea; both which are FDA approved for treating DME.

Laser surgery (Photocoagulation)

  • A common treatment for some forms of retinopathy.
  • A precision laser is used to seal leaking or bleeding vessels.
  • An outpatient procedure performed in a Vistar Eye Center.
  • Procedure takes a few minutes to one-half hour.
  • After laser surgery, additional laser surgeries may be required.
  • Performed under local or topical anesthesia.
  • Pan-Retinal Photocoagulation laser treatment may be needed for advanced stages:
    • A broad laser used to treat many places on the retina
    • Prevents the growth of new, unhealthy blood vessels
    • Procedure takes 15 – 60+ minutes
    • Usually requires 2-3 initial surgeries

Vitrectomy

  • Performed in an outpatient hospital setting or ambulatory surgery center
  • A surgery to correct unhealthy vessel growth, scar tissue, and bleeding.
  • A small suction tool is used to remove the vitreous gel containing blood and scar tissue strands inside the eye.
  • A salt solution replaces the removed vitreous jelly.
  • Performed under either local or general anesthesia.

Recovery

  • Patients may not be able to drive themselves home following either procedure.
  • Following Laser Surgery (Photocoagulation):
    • Normal activities may be resumed.
    • Wear sunglasses home to protect your dilated pupils.
    • Vision may be blurry for the rest of the day.
  • Following a Virectomy:
    • Eyes will be red and sensitive.
    • An eye patch may be needed for a few days or weeks.
    • Medicated eyedrops will be prescribed.

Sight After Treatment

Laser surgery and appropriate follow-up care can reduce the risk of blindness by 90 percent.

  • Sight improvement varies and is very dependent on each patient’s individual eye health.
  • Surgery cannot always restore vision that has already been lost.
  • If you have lost some sight before treatment, low vision services and devices will be prescribed.
  • Following a Vitrectomy, your final visual outcome may take at least a few weeks.
  • Following Laser Surgery (Photocoagulation), vision may be blurry for up to 24 hours.

*Information supplied by the Prevent Blindness America.