Understanding and Managing Diabetic Retinopathy

By 2045, the global prevalence of diabetes is projected to affect 1 in 8 adults or 783 million people. [1] Along with this growth is the rise in complications associated with the disease, including heart disease, chronic kidney disease and peripheral neuropathy. High blood sugar also leads to serious vision problems, including diabetic retinopathy. Diabetic retinopathy is the leading cause of blindness in adults aged 20 to 74.[2]

 Using data from the CDC and US Census Bureau, a team of researchers estimated for 2021 that approximately 9.6 million people had diabetic retinopathy, which is 26.43 of all individuals who have diabetes. Furthermore, of these 9.6 million people with diabetic retinopathy, researchers estimated that 5% or 1.84 million have vision threatening forms of the condition. [3] Yet, according to the CDC, 90% of vision loss from diabetes is preventable.[4]

 Understand diabetic retinopathy

Diabetic retinopathy occurs when high blood sugar damages blood vessels in the retina, which is the light-sensitive layer of cells in the back of the eye. The damaged blood vessels can swell and leak. The result is blurry vision or blood flow stops. New blood vessels may grow, but they are not normal and can cause further vision problems. The condition usually affects both eyes.[5]

Despite the severity of the condition, a recent study conducted by John Hopkins found that less than half of all Americans with diabetes-related eye damage know that diabetes can lead to vision loss. Researchers point out that the lack of knowledge can increase the risk of blindness if people do not get early eye checks and vision-protecting treatment.[6]

Know the diabetic retinopathy stages

Diabetic retinopathy is a progressive disease of which there are two categories and four diabetic retinopathy stages. The two categories include:[7]

·         Non-proliferative retinopathy (NPDR): No presence of abnormal blood vessel growth within the affected retina tissues.

·         Proliferative retinopathy (PDR):  There is presence of abnormal cell growth within affected retina tissue cells.

The four diabetic retinopathy stages are:

Mild nonproliferative diabetic retinopathy: Swelling in tiny areas in the retina blood vessels. Small amounts of fluid may leak into the retina in this diabetic retina stage, triggering swelling in the center of the retina called the macula.

Moderate nonproliferative diabetic retinopathy:  More vessels that support and nourish the retina become weak and blocked, losing their ability to transport blood to the retina. Blood and other fluids accumulate in the macula.

Severe nonproliferative diabetic retinopathy: In this third diabetic retinopathy stage, more blood vessels become blocked, which disrupts blood flow to the area. In response, the body sends signals to the retina to grow more blood vessels.

Proliferative diabetic retinopathy: In this advanced diabetic retinopathy stage, new blood vessels form in the retina. But because they often are weak, they do not work efficiently, increasing the likelihood of leaking and bleeding. Other vision problems may result including blurriness, reduced field of vision and possibly blindness.

Diabetic retinopathy symptoms

 Symptoms of diabetic retinopathy include:[8]

• blurry vision
• distorted vision
• poor night vision
• loss of vision
• decreased field of vision
• change in colors

Steps for diabetic retinopathy treatment

Control your blood sugar: Control your blood glucose levels to prevent the problems that can result, including blurry vision caused by changes in the shape of your eye and damaged blood vessels.

Medications: Take diabetes medications as directed by your doctor.

Maintain healthy blood pressure and cholesterol levels: High blood pressure and high cholesterol can put you at greater risk for eye disease and vision loss.

Exercise: Exercise is not only good for diabetes management, but also for your eyes. Research studies indicate that being less sedentary and engaging in more physical activity have been linked to the delayed onset and progression of diabetic retinopathy and less severe forms of the condition.[9]

Annual eye exam: Have an annual dilated eye exam at least once a year since in its initial stages, there may be no signs of diabetic eye disease. When your eyes are dilated, your ophthalmologist can examine the retina and optic nerves thoroughly to look for signs of eye damage before there are changes to your vision. If there are signs of the disease, your doctor can begin treatment at once.

Managing your diabetes and scheduling regular eye exams can help to prevent potential diabetes vision problems. If problems develop, taking the actions described above can help your vision problems from getting worse.