What is diabetic retinopathy?
Diabetic retinopathy is an eye condition that may lead to impairment of eyesight or even blindness in people with diabetes. Diabetic retinopathy is a leading cause of blindness in adults. Retinopathy affects small blood vessels in the retina, a light-sensitive layer of tissue on the back of the eye.
What are the symptoms of DR?
Often, there are no early signs. People developing the disease might even have 20/20 vision. Sometimes, they may develop difficulty reading or seeing faraway objects - symptoms that could easily be attributed to “regular” and less dangerous problems .
This early stage is called non-proliferative diabetic retinopathy (NDPR) and while the damage may not be fully reversible at this point, it is manageable with proper treatment, preventing any significant loss of vision.
Until recently, the only way to detect NDPR before any noticeable symptoms was through retinal examination by a trained eye doctor.
The second stage, called proliferative diabetic retinopathy (NPR), is when damage to the blood vessels is significant enough to cause blurriness of vision, which can progress to only being able to tell light from dark. Management through treatment is, again, possible, but in most cases full vision can not be restored.
General symptoms to watch out for:
Blur in the center of vision
Straight lines that look curved
Blind spots or spots
Colors that look dull or washed out
Diabetic retinopathy can lead to other serious eye conditions:
Diabetic macular edema (DME)
Over time, about 1 in 15 people with diabetes will develop DME. DME happens when blood vessels in the retina leak fluid into the macula (a part of the retina needed for sharp, central vision). This causes blurry vision.
Neovascular glaucoma
Diabetic retinopathy can cause abnormal blood vessels to grow out of the retina and block fluid from draining out of the eye. This causes a type of glaucoma (a group of eye diseases that can cause vision loss and blindness).
Retinal detachment
Diabetic retinopathy can cause scars to form in the back of your eye which can pull the retina away from the back of the eye.
Who is at risk?
Anyone with any kind of diabetes, including gestational diabetes (which can occur during pregnancy) can get diabetic retinopathy.
Risk factors:
Having diabetes for a long time
Poor control blood sugar level
High blood pressure
High cholesterol
Pregnancy
Tobacco use
Black, Hispanic or Native Americans are at higher risk
Prevention and treatment
Diabetes causes high blood sugar which damages all blood vessels, including ones in the retina. Good management of diabetes can lower the overall risk of diabetic retinopathy. This means regular physical activity, eating healthy, monitoring blood sugar levels and regularly taking medication as prescribed.
With early detection and at an early stage, regular dilated eye exams (every 2 to 4 months) may be the recommended treatment (watch and wait). In later stages, and especially if vision degradation has already occurred, treatment should start right away to halt further damage. Treatment may consist of:
Anti-VEGF drugs
Damage to small blood vessels of the retina is partly caused by the overproduction of a protein called vascular endothelial growth factor (VEGF). Anti-VEGF drugs are injected into the eye to block the harmful effects of this protein.
Corticosteroids
Corticosteroids also combat VEGF by reducing its production as well as reduce the occurrence of diabetic macular edema (DME)
Laser treatment
Scatter laser surgery is used to reduce the growth of new abnormal blood vessels as well as treat existing damaged ones.
Eye surgery
Vitrectomy can be used to remove accumulated blood in the middle of the eye as well as deal with scar tissue in more advanced stages of diabetic retinopathy.
There is however currently no cure to fully reverse existing damage. The only path to preventing diabetic retinopathy complications is through early detection by regular screening, ideally at least once a year. This is a challenge, because there are not enough eye doctors to screen all the patients with diabetes.
The total number of individuals worldwide with diabetes is expected to increase from 387 million to 592 million people by 2035.
The worldwide prevalence of DR in patients with type 1 DM is 77.3%, and with type 2, it is 25.1%.
Poor diet and lifestyle contribute to the increase in diabetes and DR prevalence.
https://www.aao.org/topic-detail/diabetic-retinopathy-latin-america
How Vitazi.ai can help
Technology has the potential to improve access to eye screening, reducing the progression of the disease for many and improving lives. If a screening could be done in minutes as part of a regular checkup, access to vital screening is solved. Going further, this could enable establishment of entirely new, systemic screening programs for several diseases within the space of Oculomics.
