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

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Diabetic retinopathy associated with fall risk
Healio
An increased risk for falling in patients with diabetes was associated with the presence of mild to moderate diabetic retinopathy, according to a study. A post hoc cross-sectional analysis of the Singapore Epidemiology of Eye Diseases study evaluated ...


MedicalResearch.com (blog)

Using AI to Spot Diabetic Retinopathy
hcanews.com
When a team of international researchers began testing a new deep learning system (DLS), they hoped to gauge how well it could identify diabetic retinopathy and similar diseases. The technology, it turned out, had a keen eye. In the primary data set ...
Deep Learning System Can Screen For Diabetic Retinopathy, Glaucoma and Macular DegenerationMedicalResearch.com (blog)
Increasing Incidence of Blindness are Expected to Impel the Growth of Diabetic Retinopathy Drug Market in Future,EIN News (press release)

all 3 news articles »

CBS Philly

Living With Diabetic Retinopathy
CBS Philly
This is one of the reasons why we try to control blood sugar early in the course of the disease. It is an overall effort to try to reduce the secondary impact of these conditions. But now there is a new report in the journal of the American Medical ...


Endocrinology Advisor

Patients With Diabetic Retinopathy Experience Barriers to Diabetes Self-Management
Endocrinology Advisor
Individuals with mild or moderate nonproliferative DR were more likely to have fallen compared to those with diabetes but without DR. Photo Credit: ISM/BARRAQUER, Barcelona. HealthDay News — Among Asians, individuals with mild and moderate diabetic ...


The Straits Times

AI system promises faster tests for 3 eye diseases
The Straits Times
Checks for eye diseases may become faster and cheaper from as early as next year, thanks to an artificial intelligence (AI) screening system that is being developed. The AI system is expected to detect three major eye diseases with greater speed and ...

and more »

Diabetic retinopathy- Epidemiology Forecast to 2023
PR Newswire (press release)
It includes 10 years epidemiology historical and forecasted data of Diabetic retinopathy prevalent or incident cases segmented by age, sex and subpopulations. The Report also discusses the prevailing risk factors, disease burden with special emphasis ...

and more »

AI system promises faster tests for eye disease
The Straits Times
With the number of diabetics here projected to reach a million by 2050, as many as 200,000 patients may have to be screened for diabetic eye diseases in future, double the 100,000 screened this year, said Prof Wong. Patients are currently screened for ...


Deep learning system identifies diabetic retinopathy, related eye diseases
Healio
A machine-learning technology known as a deep learning system showed high sensitivity and specificity for recognizing diabetic retinopathy and related eye diseases among patients with diabetes, according to data published in JAMA. “Screening for ...

and more »

St George News

Seeing diabetes: How regular eye exams can help with early ...
St George News
Image of an eye, date and location not specified | Photo courtesy of Chombosan, iStock / Getty Images, St. George News. FEATURE — It has often been said that the eyes are the window to the soul but they can also be a window into a person's overall ...

and more »

Newsmax

Greater risk of falling for people with diabetic retinopathy, researchers say
Diabetes.co.uk
A Singapore study of more than 9,000 people suggests those with diabetic retinopathy are at increased risk of falls. People with moderate diabetic retinopathy were nearly twice as likely to fall compared to people with diabetes who did not have any ...
Diabetics With Eye Damage Face Falling RiskNewsmax
Diabetes: Eye Healthmyfox8.com

all 4 news articles »

Newly published research provides new insight into how diabetes leads to retinopathy
Medical Xpress
Diabetic retinopathy is the most common diabetic eye disease and a leading cause of adult blindness. Chronically high blood sugar from diabetes damages the tiny blood vessels in the retina, leading to diabetic retinopathy, according to the …more. An ...


Silver Pinyon Journal

Global Proliferative Diabetic Retinopathy Therapeutics Market 2017 PanOptica, Ribomic, ThromboGenics
Silver Pinyon Journal
Proliferative Diabetic Retinopathy Therapeutics Market Global Proliferative Diabetic Retinopathy Therapeutics Market 2017 presents a widespread and elementary study of Proliferative Diabetic Retinopathy Therapeutics business at the side of the analysis ...


NTV

Red eye lesions could help predict diabetic retinopathy
Diabetes.co.uk
Pioneering eye research has shown there could be a better way of predicting diabetic retinopathy, the most common form of diabetic eye disease. Researchers say the key is looking at the location of red eye lesions which are early indicators that the ...
Eye disease affecting people with diabetesNTV
Global Diabetic Retinopathy Market 2017- Novartis, Ohr PharmaceuticalObserver of Press

all 3 news articles »

Medical Xpress

Risk of falls up with mild, moderate diabetic retinopathy
Medical Xpress
The researchers found that 13.2 percent of patients without diabetes, 16.3 percent with no DR, 14.2 percent with minimal DR, 26.2 percent with mild DR, 27.2 percent with moderate DR, and 19.9 percent with vision-threatening DR had a history of falls ...


Everyday Health, Inc. (blog)

What to Know About the ADA's 2018 Standards of Medical Care if You Have Diabetes
Everyday Health, Inc. (blog)
Living with poorly controlled blood sugar levels may lead to potentially serious health complications for people with diabetes — including diabetic neuropathy, diabetic retinopathy, amputations, depression, sexual issues, heart disease, stroke, and ...

and more »

Medical Xpress

Artificial intelligence promising for CA, retinopathy diagnoses
Medical Xpress
Daniel Shu Wei Ting, M.D., Ph.D., from the Singapore National Eye Center, and colleagues assessed the performance of a DLS for detecting referable diabetic retinopathy and related eye diseases using 494,661 retinal images. The researchers found that ...


Deccan Chronicle

Diabetics with related eye damage have increased falling risk
Reuters
(Reuters Health) - People with diabetic retinopathy are more likely to fall than diabetics who have not developed vision problems, a study in Singapore suggests. Among almost 9,500 middle aged and older adults, those with moderate diabetic retinopathy ...
Diabetic retinopathy ups fall risk by 31%: StudyDeccan Chronicle

all 4 news articles »

Drug to treat retinal diseases with drops instead of injections
Science Daily
A new compound, developed by the biotechnology company Sylentis, is able to penetrate the retina to treat age-related macular degeneration and diabetic retinopathy, simply with the administration of ophthalmic drops. The drug SYL136001v10, presented by ...


Oncology Nurse Advisor

Artificial Intelligence Promising for Breast Cancer Metastases Detection
Oncology Nurse Advisor
Researchers performance of automated deep learning algorithms for detecting metastases in tissue sections of lymph nodes of women with breast cancer. (HealthDay News) -- A deep learning algorithm can detect metastases in sections of lymph nodes from ...


Patient Enrolment in Phase II CIRCLE Study Evaluating THR-409 (ocriplasmin) for Non-Proliferative Diabetic ...
GlobeNewswire (press release)
Leuven, Belgium, 8 December 2017 - ThromboGenics NV (Euronext Brussels: THR), a biotechnology company developing novel medicines for back of the eye diseases and focused on diabetic eye disease, today announces that it has discontinued patient ...

and more »

The Ledger

Diabetes also affect eyes; Drugs and treatments work to stop loss of sight
The Ledger
A thorough eye exam can spot diabetes-related changes early, sometimes before people know they have diabetes. People with diabetes can get diabetic retinopathy, major cause of irreversible blindness in working age adults. It comes from ongoing damage ...

and more »

Blocking key enzyme prevents development of retinopathy in mice
Diabetes.co.uk
A six-year study of retinal inflammation in diabetic retinopathy has brought to light the actions of an enzyme that affects the development of the disease in mice. Retinopathy is a complication of diabetes caused by damage to small blood vessels in the ...

and more »

Spectropathology-corroborated multimodal quantitative imaging biomarkers for neuroretinal degeneration in diabetic ...
Dove Medical Press
Introduction: Image-based early detection for diabetic retinopathy (DR) needs value addition due to lack of well-defined disease-specific quantitative imaging biomarkers (QIBs) for neuroretinal degeneration and spectropathological information at the ...


GEOPOLMonitor

Diabetic Retinopathy Market Pipeline Review H2- Top Industry Intelligence, Major Key Players and Market
GEOPOLMonitor
Diabetic Retinopathy Market H2, latest research provides in depth analysis of Key players with pipeline review and targeted therapeutics covering drugs profile of Diabetic Retinopathy industry. Diabetic retinopathy is a complication of diabetes that ...

and more »

EndoBreak: 2018 Diabetes Care Standard; Toujeo Trial Success
MedPage Today
A deep learning system accurately identified diabetic retinopathy among other eyes diseases in a multiethnic population. Researchers suggested it could be used in a "fully-automated screening model" particularly helpful in underserved communities ...


In a world first, Singapore-developed artificial intelligence system detects 3 major eye conditions
Channel NewsAsia
SINGAPORE: Annual screenings for diabetic retinopathy to prevent vision loss will be more efficient, more accurate and more cost effective with the new artificial intelligence (AI) system developed by the Singapore National Eye Centre (SNEC), Singapore ...


EurekAlert (press release)

A drug to treat retinal diseases with drops instead of injections
EurekAlert (press release)
A new compound, developed by the biotechnology company Sylentis, is able to penetrate the retina to treat age-related macular degeneration and diabetic retinopathy, simply with the administration of ophthalmic drops. The drug SYL136001v10, presented by ...

and more »

KTAL

Nearly every diabetic will develop this eye disease
KTAL
Arkansas and Louisiana rank among the Top 10 for highest diabetes rate in the nation. This Friday AmeriHealth Caritas Louisiana is hosting free diabetic screenings at their new wellness center. Steve Bender recently spoke to an ophthalmologist about ...

and more »

Diabetic Retinopathy Market is set to garner staggering revenues by 2024
satPRnews (press release)
Diabetes is a lifelong chronic disease caused by excessive levels of glucose in the blood mainly due to lack or insufficiency of insulin hormone to metabolize the glucose in the blood. This accumulated glucose level in the blood does not reach body ...


Austrian Tribune

Diabetic retinopathy Market Report 2025 studies Type, Treatment Algorithm along with Treatment Guidelines
Austrian Tribune
Diabetic retinopathy - Market Insights, Epidemiology and Market Forecast – 2025” report provides an overview of the disease and in depth research related to Diabetic retinopathy for the 7MM (United States, Germany, France, Italy, Spain and UK) for the ...

and more »
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Dr. Pautler's Blog

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