Diabetic retinopathy is a diabetes complication that affects the back of the eye – the retina. Diabetes is a disease that damages small blood vessels, so the retina as a tissue with particularly small blood vessels and a very important function is particularly affected. It causes leakage from small, damaged blood vessels which results with imapaired vision.
Nonproliferative (early) diabetic retinopathy.
This is a more common form characterized by a weakening of the blood vessels wall in the retina that sometimes causes leakage fluid and blood into the retina. In this way, nerve fibers may get swollen. If the process occurs in the central part of the retina (macula) macular edema formswhich is a condition requiring treatment.
Proliferative Diabetic Retinopathy.
Diabetic retinopathy can progress to a heavier form, known as proliferative diabetic retinopathy. In this type of retinopathy, the damaged blood vessels become completely dysfunctional, leading to the growth of new, abnormal blood vessels in the retina that are of poor quality and can penetrate into the vitreous body (a gelatinous substance that fills the center of the eye). In this way the scar tissue may pull the retina from its natural position inducing the ablation of the retina.
Anyone with diabetes can develop diabetic retinopathy. The risk increases with:
Diabetes duration – the longer you have diabetes, the greater the risk of developing diabetic retinopathy
• Poor blood sugar control
• High blood pressure
• High cholesterol
• Pregnancy
• Smoking
Prolonged high blood levels of sugar lead to small blood vessel damage, damage to the blood vessels wall, and to their clogging or fluid leakage. As a result of all this, the tissues are supplied with less oxygen, which triggers release of the factors that stimulate the growth of new blood vessels that are of poorer quality and prone to leakage.
At an early stage, the disease may be without symptoms. As the state progresses, the following symptoms may occur:
• black spots or rows floating in the field of vision
• blurred vision
• passing vision blur
• impairment in color perception
• loss of vision or “darkening” in the part of the visual field
A complete ophthalmologic examination is carried out with the dilation of the pupils, and according to a retinologist’s opinion, further necessary examinations such as fluorescence angiography (FAG), ocular coherent tomography (OCT) and visual field examination are indicated.
The treatment primarily depends on the form of retinopathy and it is directed towards stopping or slowing the condition.
If you have mild or moderate non-proliferative diabetic retinopathy, treatment may not be necessary immediately. However, your ophthalmologist will closely monitor your eyes to determine when to begin with the treatment.
Good co-operation with diabetes specialist is needed to determine if there is a better way to control the diabetes itself. In cases where diabetic retinopathy is mild or moderate, meticulous blood sugar control can usually slow the progression of retinopathy.
If you have proliferative diabetic retinopathy or macular edema, you will need a treatment as soon as possible.
Depending on the specific pathology, the following treatment modalities are possible:
This laser treatment, also known as focal laser treatment, can stop or slow down the leakage of the blood and fluid to the retina tissue. During the procedure, leakage from abnormal blood vessels is treated with the so-called “laser spots”.
Focal Laser Treatment is usually performed in outpatient setting. If vision was already impaired because of the macular edema prior to the procedure, this treatment may not restore normal vision, but will reduce the likelihood of macular edema deterioration.
This laser treatment, also known as scattered laser treatment, reduces the number of abnormal blood vessels. During the procedure, the retinal area around macula (yellow spot, the place of clearest vision) is treated with scattered laser “stamps”.
Treatment is usually performed in outpatient setting on two or more occasions. The vision is usually blurry day after surgery.
After the procedure, peripheral vision or night vision may worsen.
Your ophthalmologist may suggest drug injection into the vitreous (a transparent gel that fills the eye and gives volume to the eyeball). These “clever” drugs, called vascular endothelial growth factor (VEGF) inhibitors, impedes growth of the new poor quality blood vessels. (link to anti-VEGF)
Your doctor may recommend these injections, also called anti-VEGF therapy, as a single treatment or in combination with panretinal photocoagulation.
These treatment modalities slow down or stop the progression of diabetic retinopathy but can not cure it, since diabetes is lifelong condition which requires permanent follow up of the diabetic patient.
The Knezović Polyclinic has many years of experience with various modalities in the monitoring and therapy of diabetic retinopathy and the top team of experts dealing with diabetes eye pathology.
Among the first in the region, we introduced a layered ocular coherent tomography (SOCT) as a prerequisite for diagnosis and monitoring of macular pathology.
Up to this date, thousands of interventions on the back of the eye have been made, with excellent results.
Price of various types of diabetic retinopathy treatment at Poliklinika Knezović – See all prices in the current PRICE LIST
Dr.sc Borna Šarić is one of the best vitreoretinal surgeons with long experience in diagnosing and treating the back ocular segment. He is a widely recognized lecturer at home and abroad at the whole spectrum of the expert meetings and pioneer in performing the most complicated procedures in the front and back part of the eye.
For all the questions fell free
to call us 01 / 66 77 222
Poliklinika Knezović
Green Gold Business Center, Tower V1, 8th floor
Ulica grada Vukovara 269f
10000 Zagreb
How to get to us?