Journal of Diabetology

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Commentary - Journal of Diabetology (2023) Volume 7, Issue 4

Understanding diabetic retinopathy: causes, symptoms, and treatment

Girish Valluru *

Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, USA

Corresponding Author:
Girish Valluru
Department of Ophthalmology
Icahn School of Medicine at Mount Sinai, New York, USA.
E-mail: gvalluru@gmail.com

Received: 01-Jul-2023, Manuscript No. AADY-23-112212; Editor assigned: 03-Jul-2023, PreQC No. AADY-23-112212 (PQ); Reviewed: 19-Jul-2023, QC No. AADY-23-112212; Revised: 21-Jul-2023, Manuscript No: AADY-23-112212 (R); Published: 26-Jul-2023, DOI:10.35841/aady-7.4.160

Citation: Valluru G. Understanding diabetic retinopathy: Causes, symptoms, and treatment, J Diabetol. 2023; 7(4):160

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Diabetic retinopathy is a common and potentially serious eye condition that affects people with diabetes. It is a progressive disease that can lead to vision loss and even blindness if left untreated. Understanding the causes, symptoms, and treatment options for diabetic retinopathy is crucial for managing this condition and preserving vision. In this article, we will delve into the intricacies of diabetic retinopathy, offering insights into its prevention and management. Diabetic retinopathy is a complication of diabetes that affects the retina, the light-sensitive tissue at the back of the eye. The condition occurs when high levels of blood sugar damage the small blood vessels in the retina. Over time, these damaged blood vessels can leak fluid and blood, leading to various vision problems [1].

Causes and risk factors

The primary cause of diabetic retinopathy is poorly managed diabetes. High blood sugar levels can damage the blood vessels in the retina, causing them to become weak and leaky. Several factors can increase the risk of developing diabetic retinopathy, including:

 

Duration of diabetes: The longer someone has diabetes, the greater their risk of developing diabetic retinopathy.

Poor blood sugar control: Maintaining stable blood sugar levels through medication, diet, and exercise is crucial in preventing diabetic retinopathy.

High blood pressure: Hypertension can exacerbate diabetic retinopathy by putting additional strain on the blood vessels in the eyes.

High cholesterol levels: Elevated cholesterol levels can contribute to the progression of retinopathy.

Smoking: Smoking increases the risk of diabetic retinopathy and can worsen the condition if it develops [2].

Symptoms

In its early stages, diabetic retinopathy may not present any noticeable symptoms. As the disease progresses, individuals may experience the following symptoms:

•

Blurred or distorted vision • Floaters (small, dark spots or lines that appear in the field of vision) • Difficulty seeing at night • Sudden vision loss It's important to note that diabetic retinopathy can affect both eyes, but symptoms may not develop simultaneously or with the same severity in each eye [3].

Stages of Diabetic Retinopathy

Diabetic retinopathy can be categorized into four stages.

Mild Nonproliferative Retinopathy: In this early stage, microaneurysms (small bulges in blood vessels) occur in the retina. Moderate Nonproliferative Retinopathy as the disease progresses, blood vessels that nourish the retina may become blocked. Severe Nonproliferative Retinopathy: In this stage, more blood vessels become blocked, leading to a significant reduction in blood flow to the retina. • Proliferative Retinopathy: At the advanced stage, new, fragile blood vessels grow on the retina's surface, which can lead to bleeding and scar tissue formation [4].

Diagnosis and treatment

Regular eye examinations are essential for individuals with diabetes to detect diabetic retinopathy early. An eye specialist (ophthalmologist) can diagnose the condition through a comprehensive eye exam, including:

 

Visual acuity test: Assessing the sharpness of vision.

Dilated eye exam: The eye doctor uses eye drops to dilate the pupils and examine the retina for signs of retinopathy.

Optical coherence tomography (oct): A high-resolution imaging test to detect swelling or fluid in the retina.

Fluorescein angiography: This test involves injecting a fluorescent dye into the bloodstream to highlight blood vessels in the eye, aiding in the detection of abnormalities.

Treatment options for diabetic retinopathy depend on the stage and severity of the condition

Lifestyle Changes: Managing blood sugar levels, blood pressure, and cholesterol through a healthy diet, exercise, and medication can slow the progression of retinopathy.

Laser Therapy (Photocoagulation): Laser treatment can seal leaking blood vessels or shrink abnormal blood vessels in the retina.

Anti-VEGF injections: Medications like aflibercept (Eylea), bevacizumab (Avastin), and ranibizumab (Lucentis) can help reduce swelling and stop the growth of abnormal blood vessels.

Vitrectomy: In cases of severe bleeding or scar tissue formation, a surgical procedure called vitrectomy may be necessary to remove the vitreous gel and replace it with a clear solution [5].

Conclusion

Diabetic retinopathy is a serious complication of diabetes that can lead to vision loss or blindness if left untreated. However, with early detection and proper management, the progression of the disease can be slowed or even halted. Regular eye examinations, effective blood sugar control, and timely treatment are essential in preserving vision and improving the quality of life for individuals with diabetes. If you have diabetes, consult with your healthcare team and eye specialist to develop a personalized plan to protect your eye health and overall well-being.

 

References

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  2. Duh EJ, Sun JK, Stitt AW. Diabetic retinopathy: current understanding, mechanisms, and treatment strategies. JCI insight. 2017;2(14).

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  3. Antonetti DA, Silva PS, Stitt AW. Current understanding of the molecular and cellular pathology of diabetic retinopathy. Nat. Rev. Endocrinol.. 2021;17(4):195-206.

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  4. Curtis TM, Gardiner TA, Stitt AW. Microvascular lesions of diabetic retinopathy: clues towards understanding pathogenesis?. Eye. 2009;23(7):1496-508.

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  5. Little K, Llorián-Salvador M, Scullion S, et al. Common pathways in dementia and diabetic retinopathy: understanding the mechanisms of diabetes-related cognitive decline. TEM. 2022;33(1):50-71.

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