Diabetic Retinopathy

What exactly causes diabetic retinopathy?:  This condition commonly results from the occurrence of a prolonged hyperglycemia, which means, high blood sugar levels in the blood.  This in turn leads to alterations in the blood vessels supplying the retina.  We are quite aware of the fact that,the  retina is a part of the eye which plays a very important role in the maintenance of a healthy vision.  With increasing blood sugar levels, blood vessels within the retina become edematous, and begin to seep out exudative fluid.  This fluid may then seep out into the macula, resulting in macular edema(swelling).  The perceptive area of the retina, which is responsible for sharp vision is the macula.  Hence, macular edema may lead to blurred vision.  

Sometimes damage to these blood vessels may also lead to the development of brush like extensions.  Apart from this, neovascularization takes place, which means new blood vessels commence to develop on the surface of the retina.  This leads to the development of deficiency of nutrients, as well as adequate oxygen to the retina.  However, these new blood vessels being usually brittle and delicate, easily allow leakage of blood into the back of the eye and cause visual disturbances such as blank areas, blockage of  vision, or glare in the presence of bright light.  sometimes, blind spots, and floaters, which are tiny spots which float across the field the vision may also occur. Formation of scar tissue may also occur, which in turn pulls the retina.  This can result in the retinal detachment.  Thus we find that, diabetic retinopathy commonly affects people suffering from diabetes since a pretty long time, and can lead to blindness.  A prolonged elevated levels of blood glucose can lead damage to the lenses to  in the eyes, which in turn can also result in blurred vision, caused by the swelling of the affected lens.

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Diabetic Retinopathy

A few risk factors for the development of diabetic retinopathy:  These include causes;

1.  The longer the duration a patient suffers from diabetes, the more susceptible is he/she to develop this complication.

2.  Pregnancy:  Women who have diabetes or gestational diabetes are more prone to develop complications, during their pregnancy.

3.  High blood pressure:  Usually hypertensive patients, which means diabetic patients with high blood pressure have a higher chance to develop this complication.

4.  Hypercholesterolemia:  Diabetic patients having hypercholesterolemia, which means high blood cholesterol level; increases the susceptibility to develop diabetic retinopathy.

5.  Ethnicity:  Studies have reported that, people belonging to the ethnic races such as, Hispanic or African-American,  also plays an important role in the development of the disease.  Hence, people belonging to these ethnic races are more prone to develop diabetic retinopathy.

How a diabetic patient can protect oneself from this disabling complication?:  Whatever may be the type of diabetes, a close monitoring of the blood sugar levels, and keeping the same under control  is the best method to reduce the risk for developing diabetic retinopathy.  The severity of this eye-related complication of diabetes, is directly associated with blood sugar control.  The level of glycosylated haemoglobin, HbA1C, which gives an indication of the blood glucose control, should be maintained between 6%-7%.  Apart from this, strictly following the prescribed medications along with a healthy and diabetic diet, a regular practice of exercise, adequate control of high blood pressure and high blood cholesterol level; and staying away from personal habits such as consumption of alcohol and smoking of cigarettes, are other steps to be followed to slow down the progression of the disease.  Cigarette smoke contains several toxic substances, like tobacco-specific N-nitrosamines, pesticides, arsenic, benzene, cadmium, etc.  These poisons circulate throughout the body, causing oxidative damage to the blood vessels of the macula and retina.

Besides this, smoking also elevates the blood pressure and increases the blood sugar level too, thereby making it very difficult to control diabetes.  A blood pressure of below 130/80 mm Hg is recommended by the National Institute of Health.  For the same reason, salt intake and processed foods should be cut down.  Similarly, the recommended levels of triglyceride are  less than 150 mg/DL; a level of low density lipoprotein, abbreviated as LDL cholesterol is less than 100 mg/DL; and the level of a high density lipoprotein, abbreviated as HDL cholesterol is more than 60 mg/DL.  Anaerobic exercise for a period of at least 30 minutes per day is the ideal recommendation.  A nutritious diet rich in fibre content, and low in carbohydrate content is the ideal diet advised for diabetic patients.

Prevention of Diabetic Retinopathy

Eye examination:  All diabetic patients should have their eyes examined by an ophthalmologist at least once in each year as a step to prevent diabetic retinopathy.  This includes a visual acuity test, tonometer to measure the intraocular pressure, and a thorough examination including the retina following dilation of the eyes with appropriate eye drops.  This comprehensive eye examination helps an ophthalmologist to determine the stage of this complication, that is whether it is mild nonproliferative retinopathy, which is the earliest stage; moderate nonproliferative retinopathy, which is the next stage; severe nonproliferative retinopathy; and proliferative retinopathy, which is the advanced stage of this condition.  Hence, its progression can be prevented from undergoing the treatment recommended by the ophthalmologist.

An early treatment with retinal laser surgery, or intravitreal injections have proved to be effective in the progression of diabetic retinopathy.  The presence of macular edema or any stage of diabetic retinopathy, can be evaluated by a fluorescein angiogram.  Similarly, every pregnant woman with gestational diabetes, or diabetes  should undergo a comprehensive dilated eye checkup at the earliest possible.  Studies have reported that, timely treatment and appropriate follow-up care can prevent diabetic patients with proliferative retinopathy from becoming blind in about 95%.  The key factor in the prevention of diabetic retinopathy is early detection and treatment.  Regular screening and eye examinations are hence absolutely necessary, because one may not develop any visual symptoms, before it becomes too late!

This Story, Causes and Prevention of Diabetic Retinopathy was originally published at Rxadvices on November 12, 2012 under Physical Health. Any kind of reproduction needs written consent from Rxadvices. Anybody copying this article is violating the copyrights of our website. If you find this content please notify us at http://www.rxadvices.com We welcome your effort in preventing plagiarism and copyrights violation.

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