What is Diabetic Retinopathy?

Diabetic patients experience many health complications arising from impaired blood sugar control, one of which is damage to the membrane at the back of the eye responsible for receiving visual images (the retina). Retinal damage is common in patients with diabetes and may have a progressive and debilitating impact on vision, eventually leading to blindness without treatment. The longer a person has diabetes, the higher their chances of developing diabetic retinopathy. The retina is the light-sensitive tissue at the back of the eye, lining the inside wall. As light enters the eye, through the cornea and the lens, it is then focussed onto the retina. The retina sends nerve impulses along the optic nerve and into the brain where it is interpreted as an image. If the retina is damaged, the nerve impulses are affected, and the interpreted image is distorted in the brain.  Diabetic retinopathy can occur when the blood vessels inside the retina are damaged causing them to swell or leak blood or fluid around the eye. Primarily caused by an increase in blood sugar levels a person suffering from insulin dependant and non-insulin dependant diabetes are at risk. It can lead to permanent blindness however vision loss may be prevented with early detection and regular eye examinations.

Non-proliferative Retinopathy
Is the early stage if the disease where tiny areas of bleeding or leaking from blood vessels are noticed during the eye examinations. Most patients do not notice any form of discomfort or loss of vision, even though damage to the retina may be occurring. It is very important that a person suffering from diabetes have an annual eye examination.

Proliferative Retinopathy
Is the advanced form of the disease. It occurs when new blood vessels grow to provide more blood supply to the retina. This causes it to swell as the new blood vessels are delicate and leak blood and fluid into the eye causing impaired vision, or in some cases, a sudden loss of vision.

Other Eye Diseases
People with diabetes are at higher risk of developing eye diseases. For example, the risk of developing glaucoma or a cataract is twice that of a non-diabetic person. Cataracts have a tendency to develop at a younger age in a diabetic person and the longer a person has diabetes the greater the risk of cataract or glaucoma. Diabetic retinopathy can not be fully prevented, but the risk of impaired vision or blindness can be greatly reduced by good management of diabetes. There is no way of preventing diabetic retinopathy as there are rarely any signs or symptoms until it is an advanced stage. If detected in the early stage, vision loss can usually be prevented. People with diabetes who maintain a well balanced diet and keep their blood sugar levels, blood fats and blood pressure as close to normal range have less risk of retinal disease in the long term and maintaining their sight.

Field Studies
A five year study; known as the FIELD study, conducted in the UK with 9795 participants on the affects of Fenofibrate (a drug developed to help reduce cholesterol and triglycerides in the blood) showed on a sub-study analysis that fenofibrate reduces the development or progression of both newly diagnosed and existing retinopathy patients. FIELD study investigators. Effect of fenofibrate on the need for laser treatment for diabetic retinopathy (FIELD study): a randomised controlled trial Lancet. 370. 1687-97. 2007

If you suffer from an unexpected change in vision, pain or discomfort, blurred, double or loss of vision or loss of night vision, contact your doctor, optometrist or ophthalmologist immediately. If the condition is not diagnosed or treated, complications may occur including retinal detachment or blindness.