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


Reduced diabetic retinopathy severity can enhance functional vision
Healio
BOSTON — Ranibizumab treatment for diabetic retinopathy, with or without diabetic macular edema, may regress the severity of the retinopathy to a milder stage, thus enhancing other visual function outcomes, Jeffrey R. Willis, MD, PhD, said in a study ...


Medscape

Anti-VEGF Treatment May Not Stop Diabetic Retinopathy
Medscape
BOSTON — Vascular endothelial growth-factor (VEGF) inhibitors do not necessarily stop the progression of diabetic retinopathy in people with macular edema, new research shows. "We shouldn't forget that there are some people who aren't improved at all, ...
Asia Pacific Diabetic Retinopathy Drug Market Size and outlook 2021Medgadget (blog)

all 4 news articles »

Steroid Implants Slow Diabetic Retinopathy
MedPage Today
BOSTON -- Fluocinolone acetonide implants slowed the progression of diabetic retinopathy in treated eyes compared with eyes not treated with the steroid implant, researchers reported here. Overall, a significantly lower portion of eyes treated with 0.2 ...


MobiHealthNews

Teenage team develops AI system to screen for diabetic retinopathy
MobiHealthNews
Kavya Kopparapu might be considered something of a “whiz kid.” After all, she had yet to enter her senior year of high school when she started Eyeagnosis, a smartphone app and 3D-printed lens that allows patients to be screened for diabetic retinopathy ...


Khaleej Times

UAE makes breakthrough in tackling diabetic retinopathy
Khaleej Times
In simple terms, diabetic retinopathy is caused by changes to the blood vessels of the retina. Poor glucose control and hypoxia cause new weak blood vessels to grow and leak fluid into the back of the eye (the retina). Abnormal blood vessels also grow ...


Medscape

Progress in Diabetic Retinopathy in the Spotlight at ASRS
Medscape
BOSTON — Treatments for diabetic retinopathy with new mechanisms of action and new options for age-related macular degeneration will be garnering attention here at the American Society of Retina Specialists (ASRS) 2017 Annual Meeting. Although ...


Telemedicine for diabetic retinopathy screening using an ultra-widefield fundus camera
Dove Medical Press
Materials and methods: Cross-sectional study of diabetic patients who visited the endocrinology department of a private multi-specialty hospital in United Arab Emirates between April 2015 and January 2017 who underwent UWF fundus imaging. Fundus ...


Diabetic Eye Disease Slowed with Steroid Implants
MedPage Today
Fewer eyes progressed to proliferative diabetic retinopathy within 36 months when treated with 0.2 μg/day fluocinolone acetonide (FAc) implants versus fellow-eye controls (12.5% versus 22.3%, P=0.0027), reported Raymond Iezzi, MD, of the Mayo Clinic in ...


Eye donations help Michigan researchers fight eye disease
Longview Daily News
"When people lose their vision because of a condition that they have, their loved ones might think, 'Oh, you don't want my husband's eyes or my father's eyes, he was blind from diabetic retinopathy,'" Vrba said. "But in fact, that eye tissue that's ...


Global Diabetic Retinopathy Market Insights, Epidemiology and Forecast to 2023
Medgadget (blog)
Diabetic Retinopathy – Market Insights, Epidemiology and Market Forecast-2023 Report provides an overview of the epidemiology trends of Diabetic Retinopathy in seven major markets (US, France, Germany, Italy, Spain, UK and Japan). It includes 10 years ...

and more »

Chicago Daily Herald

Free vision, diabetic retinopathy screenings to be offered Aug. 5
Chicago Daily Herald
Diabetic retinopathy is an eye condition occurring most often in people with Type 1 or Type 2 diabetes. This eye complication causes progressive damage to the retina which are the blood vessels of light sensitive tissue located at the back of the eye.


The Verge

A teenage girl has created a 3D-printed lens and app that can detect eye disease
The Verge
A teenage girl has created a 3D-printed lens that, when fitted onto a smartphone and used with an app, can give a preliminary diagnosis for people with diabetic retinopathy, reports IEEE Spectrum. Diabetic retinopathy is the most common cause of vision ...


Diabetic Retinopathy More Common in People Both Type 2 Diabetes and OSA Than Those with Type 2 Diabetes ...
Sleep Review
Obstructive sleep apnea (OSA) is a condition where the walls of the throat relax and narrow during sleep, resulting interrupting breathing, and it is common in patients with Type 2 diabetes. Meanwhile, diabetic retinopathy—the most common form of ...


Challenges in Diabetes Management: Glycemic Control, Medication ...
AJMC.com Managed Markets Network
Diabetes affects approximately 29.1 million Americans (9.3% of the US population), according to National Health and Nutrition Examination Survey (NHANES) ...

and more »

Link Between Serum Bilirubin and Diabetic Retinopathy in Type 2 Diabetes Patients
Diabetes In Control
Among many microvascular complications caused by diabetes, diabetic retinopathy remains the leading cause of blindness in the world. Past studies have shown that individuals with higher levels of bilirubin are at a decreased risk of developing diabetes ...


Startup MGZN (press release) (blog)

Sleep Mask for Diabetes Patients Coming to the UAE
Startup MGZN (press release) (blog)
Diabetic retinopathy or the diabetic eye disease is one of the most frequent complications related to diabetes. The high blood sugar levels cause progressive damage to the retina which may lead to blindness. The Dubai Accelerators which connects the ...

and more »

Medgadget (blog)

North America Diabetic Retinopathy Market Size and Outlook 2021
Medgadget (blog)
The North America Diabetic Retinopathy Market has been estimated at USD 2.14 billion in 2016 and is projected to reach USD 2.86 billion by 2021, at a CAGR of 6.05% during the forecast period from 2016 to 2021. North America leads the global diabetic ...


Medalist Study Underlines Importance of Blood Glucose Control in Older Adults with Type 1 Diabetes
Newswise (press release)
The Joslin team's earlier research among a smaller cohort of Medalists showed blood glucose control did not factor significantly in the development of microvascular complications such as proliferative diabetic retinopathy (PDR). The current study ...


Macular Degeneration (AMD) & Diabetic Retinopathy (DR) Market Forecast 2017-2027
PR Newswire (press release)
Where is the Retinal disease therapeutic market heading? If you are involved in this sector you must read this newly updated report. Visiongain's report shows you the potential revenues streams to 2027, assessing data, trends, opportunities and ...

and more »

Press of Atlantic City

Reducing health risks of diabetes
Press of Atlantic City
Diabetic retinopathy is the leading cause of blindness in American adults — affecting more than 4.1 million people. And according to the CDC, in 2014, 108,000 adults required a lower-extremity amputation and more than 52,000 developed kidney failure.

and more »

Idaho Statesman

Some Idahoans find lifestyle changes hard despite diabetes | Idaho ...
Idaho Statesman
As obesity rises in Idaho, spreading diabetes, health care costs rise as well. But some diabetics find it hard to embrace lifestyle change even as their feet go ...

and more »

No difference found in stroke type with or without anti-VEGFs
Healio
A total of 690 patients in the study group were identified as having received one or more intravitreal anti-VEGF injections for age-related macular degeneration, diabetic macular edema, proliferative diabetic retinopathy or retinal vein occlusion, and ...


Reuters

Novo Nordisk's diabetes drug succeeds in key trial (Aug 16)
Reuters
The trial results could have been offset by an increase in cases of diabetic retinopathy, which leads to vision loss, Guggenheim analyst Tony Butler noted. However, Novo Nordisk said on Wednesday the number of patients reporting an adverse event of ...
Novo Nordisk Diabetes Drug Beats Lilly's Trulicity in Head-to-Head TestXconomy
Diabetes: Novo Nordisk's Semaglutide/ Metformin Combo a Winner (ReutersMedPage Today
Semaglutide outperforms dulaglutide on HbA1c, weight-loss reduction in type 2 diabetesHealio
Drug Discovery & Development -Zacks Investment Research
all 106 news articles »

3ders.org (blog)

Eyeagnosis: 16-year-old uses 3D printing, AI to create diabetic retinopathy diagnosis device
3ders.org (blog)
The typical diagnostic procedure for diabetic retinopathy is a two-hour exam that requires an expensive retinal imager to make a thorough check of the patient's eyes. And while this exam is effective at spotting the symptoms of retinopathy, it's far ...
16 year old invents 3D printed eye test for preventing blindness in diabetics3D Printing Industry
This teen has created an affordable AI system to speed up the diagnosis of diabetic retinopathyInternational Business Times UK

all 3 news articles »

MedCity News

IBM and JDRF bring machine learning to type 1 diabetes research
MedCity News
Ng added that IBM has done previous work in the field of diabetes, including researching diabetic retinopathy and type II diabetes. Currently, the pilot project between IBM and JDRF is set to last for one year, Dunne said, with the results becoming ...

and more »

Diabetic retinopathy epidemiology historical and forecasted data till 2023
Medgadget (blog)
Diabetic retinopathy Epidemiology Forecast To 2023” provides an overview of the Diabetic retinopathy epidemiology trends in seven major markets (US, France, Germany, Italy, Spain, UK and Japan). It includes 10 years epidemiology historical and ...

and more »

MilTech

Diabetic Retinopathy Market Overview and Forecast till 2025
Medgadget (blog)
Diabetic Retinopathy Market – Competitive Landscape, Epidemiology And Market Forecast, 2025 Report discusses information on Therapy Pipeline scenario, Current Prominent Research Areas and Key Players, Collaborations details and Deal values, ...
Know in Detail about the Diabetic Eye Disease Equipment Market analysis, forecasts, and Overview and market ...MilTech

all 3 news articles »

OCTA brings understanding to managing diabetic eye disease
ModernMedicine
In the few years since OCTA was introduced, it has shown to enable better visualization of capillary abnormalities in eyes with diabetic retinopathy, allowing the identification of changes in the deep plexus that are not evident on fluorescein angiography.


The Diabetes Times

Welsh eye screening halves diabetic retinopathy numbers
The Diabetes Times
A diabetic retinopathy screening programme has halved the number of people in Wales with blindness and severe eye problems, research has suggested. The initiative, which was launched in 2003 and rolled out across the country in 2007, shows the ...


BBC News

Diabetic sight loss cut by screening, research shows
BBC News
The proportion of diabetics who go blind or suffer sight loss has almost halved since a new national retinopathy screening programme started in 2007. Swansea University research over eight years has now been published in the British Medical Journal.
Sight loss through retinopathy halved through screening interventionDiabetes.co.uk
Blindness from diabetes halves in Wales, new research revealsITV News

all 14 news articles »
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Dr. Pautler's Blog

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