Diabetic Retinopathy (DR)

Diabetic Retinopathy (DR)

Diabetic retinopathy results from abnormalities related to sugar metabolism in the body, leading to higher than normal blood sugar levels. This affects various blood vessel systems in the body, such as those in the eyes, kidneys, and nervous system.

Diabetic retinopathy is caused by the body's long-term high blood sugar levels, which lead to damage to the tiny blood vessel walls in the eyes, causing blockages, swelling, leakage, bleeding spots, retinal swelling, and the growth of new, fragile blood vessels. This can eventually lead to blindness. There are two stages of diabetic retinopathy:

1. Early stage: Abnormalities are detected in the retina, with swollen blood vessel walls. This is followed by bleeding spots, leakage of lipoprotein substances, and retinal nerve fiber deprivation of blood supply. Retinal swelling may also be found.
2. Advanced stage: New, fragile blood vessels are detected, which are prone to rupture and bleeding into the eye's vitreous fluid. Retinal detachment and eventual vision loss or blindness may occur due to tractional retinal detachment.

If new blood vessels grow on the iris, it can obstruct the flow of fluid in the eye's anterior chamber, leading to increased eye pressure and neovascular glaucoma, which is difficult to treat and can cause blindness.

Treatment

1. Medication: Emphasis is placed on treating the underlying conditions of the patient. Patients must control their blood sugar levels, blood lipid levels, and blood pressure to prevent the progression of diabetic retinopathy.
2. Laser treatment: Used for patients with retinal swelling or advanced-stage diabetic retinopathy with new blood vessels. Laser light is directly applied to the retina, causing the abnormal blood vessels to disappear and stopping the disease's progression. Some patients may require multiple laser treatments.
3. Intraocular injections: Steroid and Anti-VEGF medications can be used to treat retinal swelling due to diabetes. The advantage is that vision may return to near-normal levels without damaging the retina, but the effect is temporary.
4. Vitrectomy surgery: In severe cases with vitreous hemorrhage, tractional retinal detachment, or chronic macular edema unresponsive to laser treatment or injections, vitrectomy or retinal surgery may be required.

Self-care for diabetic patients to prevent blindness

1. Diabetic patients should have regular eye exams with an ophthalmologist.
2. Control diet and maintain blood sugar levels within the normal range, with a glycated hemoglobin (HbA1C) level of less than 7%.
3. Manage high blood pressure to keep it within the normal range.
4. Control blood lipid levels.
5. Refrain from smoking.
6. Engage in regular exercise, such as running, cycling, or swimming.
7. Take medications as prescribed.
8. Consult a doctor to better understand the disease.

In conclusion, preventing diabetic retinopathy depends on the speed and consistency of treatment as well as controlling diet and blood sugar levels to prevent complications leading to blindness.