Diabetic retinopathy

Problems with the retina caused by diabetes.

The walls of blood vessels are damaged due to elevated sugar concentration in the blood. Because of this, blood vessels leak and abnormal vessels develop in the eye. Ultimately two problems can cause blindness:

• If vision is being reduced by leaking fluid resulting in swelling in the central area of the retina, the macula.
• There is a lack of oxygen to the retina due to blood vessel blockage. As a result, it is possible for new blood vessels to grow on the retina that cause bleeding in the eye or retinal detachment (proliferative diabetic retinopathy).

Examination

It is necessary for people with diabetes to regularly have the retina examined by an ophthalmologist, even when there are no complaints. Even diabetic patients who still see well can have serious abnormalities in the eye.

In order to thoroughly examine the retina, the ophthalmologist will usually use eye drops to dilate the pupil. You will experience blurred vision for a few hours. After this examination you will not be able to drive for a number of hours.

Additional examinations that are often necessary: an OCT and fluorescein angiography.

Treatment

Intravitreal injection

The ophthalmologist injects a small amount of medicine into the eye under local anesthesia. The medicines that are used in the eye are ranibisumab, aflibercept, bevacizumab or triamcinolone. These injections are carried out in the case of swelling in the central part of the retina (macular edema) or when new blood vessels are growing on the retina. The medication works temporarily and therefore must regularly be administered again.

Laser treatment of the retina

The ophthalmologist will choose laser treatment in order to slow down the growth of new blood vessels on the retina or in some cases when there is swelling in the central part of the retina. This eye laser treatment is very different from the eye laser treatment used in order to improve sight.