Diabetic Retinopathy

Over time, high blood sugars can cause damage to retinal vessels and vision loss from diabetic retinopathy.

What is Diabetes Mellitus?

Diabetes is commonly known as elevated blood sugar. It occurs in young people who have trouble producing a substance called insulin that regulates blood sugar, as well as in older people who develop resistance to insulin as they age. Young diabetics are often referred to as Type 1, while older diabetics are ofte referred to as Type 2. There are also some diabetics who exhibit characteristics of both Type 1 and Type 2 diabetes. All types of diabetics suffer similar effects of elevated blood sugar.
When diabetes is uncontrolled it damages blood vessels throughout the body. The longer a person is diabetic and the more poorly the blood sugar levels are controlled, the more likely that person is to suffer blood vessel damage. As diabetes worsens, it first affects the smallest blood vessels, called capillaries, throughout the body. Some of the locations in the body where tiny capillaries are the most important include the kidneys, the nerves in the legs, feet, and hands, and in the light-sensing tissue of the eye called the retina.

What is Diabetic Retinopathy?

The earliest sign of small blood vessel damage in the retina is background diabetic retinopathy, also known as non-proliferative diabetic retinopathy. Background diabetic retinopathy occurs as small blood vessel disease becomes visible in the retina, and your eye doctor can see small aneurysms or hemorrhages (also known as "blood spots") in the retinal tissue at this stage. Most diabetics with background diabetic retinopathy do not know that they have this sign of advancing diabetes, since it does not always affect the vision when it is mildly or moderately severe. However, early detection of background diabetic retinopathy is crucial, as it helps the patient's primary care doctor or endocrinologist (diabetic disease specialist) know the status of the diabetic blood vessel damage throughout the body. The diagnosis of background diabetic retinopathy also lets the patient's eye doctor know that the patient is at a higher risk of vision loss than a patient without background diabetic retinopathy. The guidelines of the American Diabetes Association and American Academy of Ophthalmology reflect that all diabetics should have a dilated eye exam regularly in an effort to detect background diabetic retinopathy while it is still in its early stages.

What is a Diabetic Eye Examination?

When a patient comes to the retinal office for a diabetic eye exam, there are sometimes special imaging tests recommended by the doctor in addition to the dilated eye exam. These tests can include specific pictures of the eye with both regular color digital cameras and special laser cameras. Retinal tomography, or an evaluation of the retinal thickness and the retinal layers, is a unique technology often used to assess the structure and health of the diabetic retina. Fluorescein angiography is another specialized imaging test that allows for detailed visualization of the tiny retinal blood vessels as well as leakage from areas that are diseased. Sometimes an ultrasonic picture of the back of the eye is obtained. During your visit, your doctor will decide which of these tests are important for assessment of the retina. Not every test is recommended at every visit.

What can I do to Preserve Vision?

The cornerstone of saving vision in diabetes remains excellent blood sugar control. Over the last 2 generations, there has been ample, repeated evidence that keeping the blood sugar at an appropriate level, controlling blood pressure, and monitoring cholesterol and fats in the blood are the most effective ways to stave off diabetic retinopathy. It is very important that every diabetic has a good relationship with their primary care team and makes every effort to optimize their diabetic health. A healthy diet, regular exercise several times each week, routine at-home blood sugar monitoring as directed by your diabetic doctor, and ongoing compliance with diabetic medications are the most important part of saving vision in diabetes.

What is Background Diabetic Retinopathy?

If diabetes remains poorly controlled, background diabetic retinopathy advances as there is more and more small blood vessel damage. The small blood vessels continue to collapse and result is varying degrees of retinal ischemia, or poor blood flow to the retinal tissue due to the absence of normal blood vessel supply. Essentially, progressing diabetic retinopathy is like placing a tourniquet on the retina a slowly tightening it. There is currently no technology to restore the lost blood vessels. The lack of these blood vessels itself can cause irreversible vision loss and often limits the vision in diabetics.

What is Diabetic Macular Edema?

, There are two treatable processes that occur as there is less and less normal retinal blood flow. The first is called diabetic macular edema, which means swelling in the retina associated with diabetes. This swelling can blur and distort the vision. The swelling occurs because the walls of the small blood vessels are progressively more damaged in diabetes, and there is leakage of blood and fluid into the cells of the retina.

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What is Proliferative Diabetic Retinopathy?

The second treatable process in diabetic retinopathy is the growth of abnormal new blood vessels in the eye. This process is called proliferative retinopathy. The abnormal new blood vessels in the eye probably appear in response to progressive absence of normal blood vessels, and this is an even more ominous process than diabetic macular edema. Often there is both diabetic macular edema and proliferative diabetic retinopathy in the same patient at the same time. The abnormal new blood vessels seen in proliferative retinopathy are fragile and often will bleed into the vitreous jelly filling the back of the eye. This process is called vitreous hemorrhage, and patients will often see hundreds of spots, swirls, or lines when vitreous hemorrhage begins. Sometimes the hemorrhage can be so dense that there is severe blurring of vision. As the abnormal new blood vessels continue to grow, they get denser and thicker. This process can lead to tugging or traction on the retina, and that is termed a diabetic tractional retinal detachment. Diabetic retinal detachment is the most serious and advanced stage of diabetic retinopathy. Abnormal new blood vessel growth in the eye can be treated in its earlier stages with laser therapy. The laser technique is much different than that applied to diabetic macular edema.

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What is a Vitreous Hemorrhage?

Patients with diabetes develop weak blood vessels in the retina that are prone to bleeding. If bleeding occurs into the vitreous cavity, patients will see many tiny floaters and develop moderate to severe vision loss. The blood inside the eye doesn't harm the eye but it does block the vision. Blood inside the eye will sometimes absorb within a few weeks or months. When the blood absorb the vision improves. If the blood doesn't asborb, vitrecotmy surgery can be performed to improve the vision. Because of the risk of surgery, most surgeons wait anywhwere from one month to 6 months depending on the situation to see if the blood will clear without surgery.

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What is a Diabetic Tractional Retinal Detachment?

Patients with proliferative diabetic retinopathy sometimes develop a tractional retinal detachment. This can occur when scar tissue grows on the surface of the retina and then contracts or is pulled forwward in the eye by the vitreous. When this happens, the retina, which is stuck to the diabetic scar tissue, pulls away from the back of the eye and away from its blood supply. The vision declines and the retina suffers. Tractional retinal detachments can usually be prevented if sufficient pan-retinal laser is administered before the scar tissue progresses. Once there is a tractional retinal detachment surgery can be helpful.

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Diabetic Retinopathy NEWS

Below are current articles from a Google News Feed on Diabetic Retinopathy


Diabetic Retinopathy Market Research Report Forecast to 2025
Medgadget (blog)
Diabetic Retinopathy is one of the common diabetic eye diseases characterized by the damaged blood vessels in the retina. The damaged blood vessels and nerves lead to blurring of vision, vision impairment, and eye hemorrhage. If left untreated, it may ...


Anti-VEGF for Diabetic Retinopathy: A 'Strong Option'
MedPage Today
Despite promising findings with the use of anti-VEGF injections for the treatment of proliferative diabetic retinopathy (PDR) in two recent trials, concerns about these injections limit it's implementation into widespread clinical use, according to an ...


Endocrinology Advisor

Geographic Information Systems Pinpoint Barriers to Eye Care for Diabetic Retinopathy
Endocrinology Advisor
HealthDay News — Geographic information systems mapping can visualize geographic access barriers to eye care among patients with diabetes, while telescreening can increase the rate of diabetes retinopathy evaluation, according to 2 studies published ...


Hindustan Times

New biomarkers predict accelerated diabetic eye disease
Science Daily
Diabetic retinopathy (DR) is one of the late complications of diabetes and usually it affects people who have had diabetes for considerably longer duration. Research [1] from the Madras Diabetes Research Foundation (MDRF), India has now demonstrated ...
Study shows biomarkers linked with diabetic retinopathy risk in young peopleDiabetes.co.uk
Youngsters with diabetes more at risk of eye diseaseHindustan Times

all 4 news articles »

Local healthcare professionals give their best advice for optical disease prevention
Southeast Missourian
"Diabetic retinopathy can lead to permanent vision loss, and so, optometrists and ophthalmologists will recommend at least yearly eye exams for diabetic patients (more often for those with existing diabetic retinopathy)," he says. Eye care ...


OSA Linked to Sight-Threatening Diabetic Retinopathy in Type 2 Diabetes
Psychiatry Advisor
HealthDay News — For patients with type 2 diabetes, obstructive sleep apnea (OSA) is associated with sight-threatening diabetic retinopathy (STDR) and with progression to pre-/proliferative DR, according to a study published online in the American ...


Telehealth program reduced unneeded diabetic retinopathy referrals
ModernMedicine
The Los Angeles County Department of Health Services safety net clinics successfully implemented a primary care-based teleretinal diabetes retinopathy screening (TDRS) program, eliminating the need for more than 14,000 visits to specialty care ...


Strategies to encourage more patients to undergo eye tests
Healio
PHILADELPHIA — Education, along with a screening reminder card, may encourage more patients to get diabetic retinopathy eye screening exams, according to a presenter here at the annual meeting of the American Association of Nurse Practitioners.


Quartz

A Google algorithm could help Indian diabetics avoid a disease that leads to blindness
Quartz
One of the fastest growing causes of blindness around the world is an eye disease that's almost entirely preventable. Diabetic retinopathy is a condition that occurs among diabetics when high blood sugar levels damage the retinal blood vessels, leading ...
Google working with Aravind Eye Hospital to train its AI in diabetic retinopathy screeningFactorDaily

all 2 news articles »

Future of Diabetic Retinopathy Market – Growth Opportunities & Global Scenario, 2014-2022
Medgadget (blog)
Diabetic retinopathy (DR) is a medical condition of the eye, which is prevalent in a diabetic individual. It is mainly caused due to damage of the blood vessels of the light-sensitive tissue present at the back of the eye. Without timely treatment, the ...


Telemedicine brings doctor to people with diabetic eye disease
Futurity: Research News
Telemedicine can increase the number of people with access to medical evaluation for diabetic retinopathy, particularly for minority, rural, and typically underserved populations, new research suggests. Seema Garg, a retina specialist and associate ...


UWF-FA identifies retinopathy earlier than UWF photography alone
Healio
In eyes with less severe diabetic retinopathy, ultra-widefield fluorescein angiography identifies the more severe form earlier and allows for identification of nonproliferation not readily evident on ultra widefield color images, according to ...


6minutes

Why diabetic retinopathy is set to surge
6minutes
GPs play a central role in diagnosing and managing diabetic retinopathy, which affects half of patients with diabetes, according to Professor Paul Mitchell, Professor of Clinical Ophthalmology & Eye Health at Westmead Clinical School at the University ...


NHANES: Vitamin D deficiency may worsen retinopathy in well-controlled type 2 diabetes
Healio
Middle-aged adults with well-controlled type 2 diabetes and vitamin D deficiency may be more likely to develop mild or severe diabetic retinopathy when compared with adults who have well-controlled diabetes without vitamin D deficiency, according to an ...


Medgadget (blog)

Diabetic Retinopathy Market Expected to Reach $2490 Million, Globally by 2022
Medgadget (blog)
There have been remarkable advancements in the diagnosis and treatment of diabetic retinopathy in the recent years. Rapid adoption of intravitreal pharmacological agents such as anti-VEGF drugs, and corticosteroids have led to improvement of vision in ...
Diabetic Retinopathy 2017 Market Segmentation Application, Technology & Market Analysis Research Report to 2022satPRnews (press release)

all 2 news articles »

Healio

Retinal Ganglion Cell Loss in Children With Type 1 Diabetes Mellitus Without Diabetic Retinopathy
Healio
Type 1 diabetes mellitus (T1DM) is a chronic disease requiring long-term control and monitoring of chronic complications such as nephropathy, vasculopathy, and retinopathy. Diabetic retinopathy (DR) may lead to blindness resulting from not only ...


Los Angeles Times

A simple test is helping thousands of diabetics in LA County who face an increased risk of going blind
Los Angeles Times
The condition, called diabetic retinopathy, is the leading cause of blindness among working-age adults nationwide. A simple test can detect and help treat the problem, but four years ago most diabetics in Los Angeles County's massive healthcare system ...


Evaluate hemorrhages, microaneurysm with UWFI to determine DR progression risk
Healio
More peripheral and total microaneurysms were associated with increased diabetic retinopathy progression over 4 years in patients with mild to moderate nonproliferative diabetic retinopathy at baseline, according to research presented at the ...


Medical News Bulletin

For Your Eyes Only: Anti-VEGF Therapy to Treat Diabetic Retinopathy
Medical News Bulletin
A prospective secondary analysis of randomized clinical trial with 650 participants who underwent intra-vitreous anti-vascular growth factor (VEGF) therapy showed that at the end of 1 and 2 years, there was an improvement in diabetic retinopathy ...


EurekAlert (press release)

Lloyd Paul Aiello receives JDRF Award for Excellence in Type 1 Diabetes Clinical Research
EurekAlert (press release)
Dr. Lloyd Paul Aiello was the inaugural chair of the Diabetic Retinopathy Clinical Research Network and focuses his clinical and research interests on eliminating vision loss due to diabetic retinopathy and other related retinopathies. His research ...

and more »

The British Hungarian Society Hosts Professor Tibor Frank's Fascinating International Relations Talk: "Hungary and ...
Benzinga
The committee includes Countess Ilona, Professor Dr Eva Kohner, who was awarded an OBE for her ground-breaking work in treating Diabetic Retinopathy, and Adrian Longley OBE, a notable solicitor, Robin Hutchinson, the Treasurer Paul Boon CF, and ...

and more »

Signs and Risk Factors for Eye Disease
News-Medical.net
Eye diseases are widespread around the globe. According to the World Health Organization, the most important three eye diseases or conditions that are a potential threat to the global population are diabetic retinopathy, glaucoma, and age-related ...


Sleep Apnea Linked to Diabetic Retinopathy in Type 2 Diabetes
Doctors Lounge
For patients with type 2 diabetes, obstructive sleep apnea is associated with sight-threatening diabetic retinopathy and with progression to pre-/proliferative diabetic retinopathy, according to a study published online June 8 in the American Journal ...


Ziegler Advises Intelligent Retinal Imaging Systems on its Series B Growth Funding
Benzinga
IRIS is the industry leader in early detection systems for diabetic eye disease. The IRIS solution is an end-to-end, FDA-cleared, telemedicine system that has improved quality, expanded access and reduced costs for diabetic retinopathy exams across the ...

and more »

Diabetic Retinopathy-Epidemiology Forecast To 2023
Medgadget (blog)
The study of Diabetic Retinopathy-Epidemiology Forecast To 2023 is very important to enhance business productivity and for the study of market forecast. This New Report presented by Orbis Reseach contains a comprehensive market and vendor landscape ...


The Herald-News

Diabetic retinopathy can steal vision
The Herald-News
Diabetic retinopathy is a disease of the eye resulting from diabetes that can adversely affect vision. The diabetes causes a person's blood sugar level to be high, damaging the blood vessels in the retina. The blood vessels can either swell and leak ...

and more »

Regeneron (REGN) Stock on Fire: What's Behind the Surge?
Zacks.com
Meanwhile, Regeneron is working on expanding Eylea label into additional indications for the treatment of moderately severe to severe non-proliferative diabetic retinopathy in patients without DME and neovascular glaucoma. Label expansion into ...

and more »

R & D Magazine

Novel Tech Pushes Diabetes Treatment in New Direction
R & D Magazine
Computing giants like IBM are using a mix of deep learning and visual analytics to predict and diagnose the severity of diabetic retinopathy, a condition where high blood sugar levels inflict harm on the retina. Over 35,000 eye images were used to ...

and more »

Intelligent Retinal Imaging Systems Raises Series B Growth Funding
Markets Insider
The IRIS retinal telemedicine platform was developed to help end preventable, permanent blindness caused by diabetic retinopathy through early diagnosis. The IRIS platform is in place at 94 health systems across 28 states. IRIS seamlessly sits within a ...


Follow-up of the retinal nerve fiber layer thickness of diabetic patients type 2, as a predisposing factor for ...
Dove Medical Press
For the purposes of the study, 27 eyes of diabetic patients without diabetic retinopathy, 24 eyes of patients with mild retinopathy, and 25 normal age-matched subjects (control group [CG]) were examined. All participants underwent complete ...

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