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Diabetic retinopathy currently affects more than 7 million Americans, and the National Eye Institute (NEI) projects an increase to more than 14 million people by 2030.
Diabetic retinopathy is the leading cause of blindness in working-age adults.
If you have diabetes, you can prevent vision loss by managing your blood sugar and blood pressure.
It is also important to visit your eye doctor each year for a dilated exam to examine the retina for diabetic retinopathy.
Some vision-threatening complications from diabetes can only be seen on a dilated exam, so it is recommended you get regular examinations, even if you are seeing clearly.
At University of Maryland Medical Center, our Center for Diabetes and Endocrinology at the UMMC Midtown Campus will help you monitor and manage all the possible complications of diabetes, working closely with our expert team of eye doctors to manage diabetic retinopathy.
What Is Diabetic Retinopathy?
High blood sugar damages blood vessels throughout the body. In the delicate tissue of the eyes, this damage can cause diabetic retinopathy. People with all types of diabetes — including type 1, type 2 and gestational diabetes (diabetes that develops in response to pregnancy) — can develop diabetic retinopathy.
The retina functions like the "film" in a camera. Just as damage to film would worsen image quality, diabetic retinopathy can cause blurry vision.
The macula is the center of the retina responsible for central vision. Damage to blood vessels supplying the macula can cause them to leak fluid, called macular edema. Patients can notice this as blurry vision.
In the later stages of diabetic retinopathy, the body responds to the damaged blood vessels by growing new blood vessels. This is called proliferative diabetic retinopathy. Unfortunately, these blood vessels are more fragile and they can bleed, causing vitreous hemorrhage, or scar, causing retinal detachment and subsequent permanent blindness.
Diabetic Eye Exam
Early detection, along with timely treatment and appropriate follow-up care, can reduce the risk of severe vision loss.
At the beginning, there may be no symptoms, but if left untreated it can progress to blindness.
Diabetic Retinopathy Symptoms
As diabetic retinopathy progresses you may experience:
- Blurred or changing vision
- Floaters (spots or dark strings)
- Dark or empty areas of your vision
- Vision loss
Diabetic Retinopathy Treatment
The first line of treatment, when the disease is caught in the early stages, is improving glucose control and blood pressure (if you have hypertension). You may need to examined by your eye doctor as often as monthly.
Some common treatments for diabetic retinopathy include:
A protein called VEGF, which is produced in diabetic retinopathy, increases blood vessel leakage and swelling. Injections of anti-VEGF medication, which block VEGF, can be an effective treatment, reduce blood vessel leakage and swelling in the macula, the center of the retina. Steroid injections can also be used to treat macular swelling.
Injections are given in the office under local anesthesia. For most patients starting treatment, they are given monthly for the first 3 months and often needed on an ongoing basis.
Scatter Laser Surgery (Panretinal Photocoagulation)
This type of laser eye surgery treats advanced diabetic retinopathy where there are abnormal blood vessels that can bleed and fill the eye with blood (proliferative diabetic retinopathy). These abnormal blood vessels are thought to grow in response to areas of the retina which are not getting enough blood flow. Laser is used to destroy these areas that are not getting blood flow, in order to shrink these problematic abnormal blood vessels.
The vitreous, the gel substance inside the eye, can become cloudy in people with diabetic retinopathy because of bleeding. During vitrectomy, your eye surgeon removes the blood and the eye refills with a clear fluid. Vitrectomy is also used to remove scar tissue to repair retinal detachments from diabetes.
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The specialists at University of Maryland Eye Associates are here to monitor your eye health before you develop complications and to treat any that do arise.
Associate Professor of Ophthalmology