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


World Health Organization

Nepal tackles diabetic retinopathy
World Health Organization
Diabetic retinopathy, which contributes to 2.6% of blindness in the world, can be a challenging disease for many countries to manage, because doing so involves two different parts of the health system, that which cares for patients with diabetes and ...


ThromboGenics Business Update - Q3 2017
GlobeNewswire (press release)
Diabetic retinopathy (DR) is the leading cause of visual disability and blindness among professionally active adults. More than one in three people living with diabetes (35.4%) will develop some form of DR in their lifetime. One in five patients with ...

and more »

Medscape

Eyedrops for Diabetic Retinopathy Possible in the Future?
Medscape
In one, neurodegeneration appears at the beginning and perhaps is important in the pathogenesis of diabetic retinopathy.…But in some patients, we just found microangiopathy without neural dysfunction. This was a surprise….We have to understand more ...


Medical Xpress

New screening tool can identify diabetic retinopathy
Medical Xpress
"We developed a low-cost and easy-to-apply screening tool to detect people at high risk of diabetic retinopathy in Mexico," the authors write. "Although classification performance of our tool was acceptable (AUC ROC > 0.75), error rates (precision ...

and more »

News-Medical.net

Scientists identify potential treatment target for diabetic retinopathy
News-Medical.net
Now scientists have identified a new target for reducing that dysfunctional blood vessel development in the eye in a common condition called diabetic retinopathy, the leading cause of blindness in working-age adults. "If we block the adenosine receptor ...

and more »

The Gazette: Eastern Iowa Breaking News and Headlines

FDA gives Novo Nordisk top grades for its diabetes drug semaglutide, but retinopathy remains key
Endpoints News
There will be close attention to evidence of diabetic retinopathy, as the FDA carefully pointed the panel to data suggesting that a rapid drop in HbA1c could cause safety problems for patients. But the overall positive tenor in the review clearly ...
Novo Nordisk diabetes drug effective and has no heart risk, preliminary FDA review findsThe Gazette: Eastern Iowa Breaking News and Headlines
FDA digs into semaglutide CV benefits, eye safety ahead of Novo Nordisk drug's panel reviewFiercePharma

all 6 news articles »

Global $13.1 Bn Diabetic Retinopathy Market, 2025
PR Newswire (press release)
The global diabetic retinopathy market was valued at USD 8.4 Bn in 2017, and is expected to reach USD 13.1 Bn by 2025, expanding at a CAGR of 6.7% from 2017 - 2025. Perpetual growth in the prevalence of diabetes in middle- and low-income countries ...

and more »

Iowa Now

UI physician to brief Congress on how research spurs economy
Iowa Now
Based on over 20 years of research, Abràmoff founded IDx with the goal of increasing health care productivity and commercializing an automated diagnostic tool for diabetic retinopathy, a leading cause of preventable blindness. IDx has worked closely ...


The New Indian Express

Awareness of diabetic retinopathy among patients with type 2 diabetes mellitus in Jordan
Dove Medical Press
Background: Increasing the level of awareness of diabetic retinopathy among individuals with type 2 diabetes mellitus is considered an important factor for early diagnosis and management of diabetic retinopathy. The aim of this study was to evaluate ...
Awareness is the greatest agent for changeThe New Indian Express

all 2 news articles »

Reuters

Novo Nordisk takes aim at Eli Lilly with US backing of new diabetes drug
Reuters
Panelists discussed data showing semaglutide was associated with an initial worsening of diabetic retinopathy, a condition caused by damage to blood vessels in the retina due to high blood sugar levels. The damage can cause progressive deterioration in ...
FDA experts shrug off retinopathy concerns, offer (near) unanimous thumbs up for Novo Nordisk's semaglutideEndpoints News
FDA Panel Gives Nod to Once-Weekly Semaglutide for Type 2 DiabetesAJMC.com Managed Markets Network
FDA advisory committee supports once-weekly semaglutide for type 2 diabetesHealio
MedPage Today -FiercePharma -Zacks Investment Research
all 115 news articles »

AntriaBio Announces Selection of Lead Oral Plasma Kallikrein Inhibitor Candidates for the Treatment of Diabetic ...
GlobeNewswire (press release)
“Despite recent advances in the treatment of Diabetic Retinopathy, we need new therapies to better control this disease via alternative molecular pathways and a non-invasive drug delivery route that allows for self-administration by patients,” stated ...

and more »

Anti-VEGF Therapy Slows High-Risk Retinopathy
MedPage Today
CHICAGO -- More than three-fourths of patients with moderate or severe nonproliferative diabetic retinopathy had significant improvement when treated with ranibizumab,, a retrospective review of two randomized trials showed. At least a two-step ...


Eye drops could help treat diabetic retinopathy
Diabetes.co.uk
In one, neurodegeneration appears at the beginning and perhaps is important in the pathogenesis of diabetic retinopathy," said Simo during an interview with Medscape Medical News. "But in some patients, we just found microangiopathy without neural ...


Medical Xpress

No causal link between plasma lipids, diabetic retinopathy
Medical Xpress
(HealthDay)—There does not seem to be a causal relationship between plasma lipids and diabetic retinopathy (DR), according to a study published in the September issue of Diabetes. Lucia Sobrin, M.D., M.P.H., from Harvard Medical School in Boston, and ...


Early Treatment of Diabetic Retinopathy and Diabetic Macular Edema: Optimal Use of Anti-VEGF Therapy for Vision ...
Healio
Diabetic retinopathy (DR) and diabetic macular edema (DME) are 2 of the most common causes of blindness among working-age people throughout the world. Effective management depends heavily on prompt treatment. Many of these patients remain ...


Medscape

Bariatric Surgery May Reduce Retinopathy Risk, Progression
Medscape
LISBON, PORTUGAL — Roux-en-Y gastric bypass (RYGB) surgery reduces the risk for retinopathy in obese patients with type 2 diabetes, whether or not they experience diabetes remission following the operation, new research indicates. Findings from the ...


Lions offer free diabetic retinopathy screening
DeKalb Daily Chronicle
GENOA – A free diabetic retinopathy screening for people with diabetes or those at risk for diabetes will take place from 4 to 8 p.m. Oct. 12 at the Lions of Illinois Screening Bus at the southwest corner of Route 23 and Central Street in Genoa. The ...


HAP to Provide Free In-home Vision Screenings for Diabetic Medicare Members
Markets Insider
DETROIT, Oct. 17, 2017 /PRNewswire/ -- Health Alliance Plan is dedicated to helping its members combat diabetic retinopathy, which is a major cause of blindness. To fight this debilitating condition, HAP is offering mobile diabetic retinopathy ...

and more »

Silmäasema Oyj: Silmäasema supports the proposal of using client vouchers to pay for treating cataract and other eye ...
GlobeNewswire (press release)
In the future, client vouchers can be used to pay for non-emergency medical appointments with healthcare professionals, such as regular follow-up appointments for glaucoma, diabetic retinopathy and age-related macular degeneration. "We are pleased with ...

and more »

Coveleaderpress

Visually impaired Copperas Cove man earns Braille Student of the Year Award
Coveleaderpress
WINNETKA, IL—Hadley Institute for the Blind and Visually Impaired has recognized Andrew Simpson of Copperas Cove with the Braille Student of the Year Award. Simpson lost his sight at the age of 25 due to diabetic retinopathy. At the time, he was ...


'20 million in India will have Diabetic Retinopathy by 2020'
The New Indian Express
VIJAYAWADA: Chief and Professor of Ophthalmology Atul Kumar stressed the need for early diagnosis and referral to cure Diabetic Retinopathy which is crucial to prevent blindness.Participating as a chief guest for the inaugural session of the two-day ...


Medscape

Low LDL Target Resulted in No Clinical Gain in Non-CAD Diabetes: EMPATHY
Medscape
BARCELONA, SPAIN — Cardiovascular risk did not drop significantly over 3 years with intensive statin therapy, compared with a standard statin regimen, in a randomized trial that entered only dyslipidemic patients with diabetic retinopathy but no ...


UCR Today (press release)

Professor Ghosh receives NIH funding to study the role of retinal capillary stiffness in diabetic retinopathy
UCR Today (press release)
Bioengineering Assistant Professor Kaustabh Ghosh (Principal Investigator) has received a five-year $1.9M R01 grant from the National Eye Institute (NEI) of the National Institutes of health (NIH) to study the “Role of Retinal Capillary Stiffness in ...


The WHO selects Tivanisiran as the international nonproprietary name for SYL1001
EurekAlert (press release)
... SLY136001, in ophthalmic drops and based on the same RNAi technology, for the treatment of the degenerative retina diseases that are identified by neovascularization, such as macular degeneration, associated to age and also diabetic retinopathy.

and more »

Medscape

Cell-Based Therapy for Dry AMD Promising in Early Trial
Medscape
"This is the third clinical trial with these cells, and what we have learned is that the cells can improve the vision of some patients with geographic atrophy. In the phase 1 trial, some gained at least 15 letters on [the Early Treatment Diabetic ...


Proliferative Diabetic Retinopathy (PDR) – Market Analysis, H2 2017
Medgadget (blog)
A new research document with title 'Proliferative Diabetic Retinopathy (PDR) – Pipeline Review, H2 2017' covering detailed analysis, Competitive landscape, forecast and strategies. The study covers geographic analysis and important players/vendors such ...
Proliferative Diabetic Retinopathy (PDR) Therapeutics Pipeline Industry Review H2 2017MilTech

all 3 news articles »

MedCity News

Key takeaways from Rock Health's annual digital health summit
MedCity News
“In diabetic retinopathy …there is an application where you can take the images, train the images and come up with some meaningful insight,” she said noting that this would serve an unmet need. “The important thing is that you work with regulators to ...


Healio

Aflibercept in Serous Foveal Detachment in Dome-Shaped Macula: Short-Term Results in a Retrospective Study
Healio
Early Treatment Diabetic Retinopathy Study best-corrected visual acuity (BCVA), optical coherence tomography central subfield thickness (CST), and subretinal fluid (SRF) at baseline and at 2 months and 4 months after the last injection were considered ...


#EAPM: Diabetes and blindness in India and beyond
EU Reporter (blog)
The Brussels-based European Alliance for Personalised Medicine (EAPM) will play a key role in an international advisory board meeting of the Diabetic Retinopathy Project, on 20 October at London's Houses of Parliament, writes European Alliance for ...


Hard Facts About Ampio Pharmaceuticals, Inc. (NYSE:AMPE)
TopChronicle
Principal products offered by the Company include Optina, an oral drug for the treatment of diabetic retinopathy and macular edema; and Vasaloc, an oral drug for the treatment of diabetic nephropathy. Ampio Pharmaceuticals, Inc. is based in Greenwood ...

and more »
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