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Is Diabetic Retinopathy Reversible

Diabetic Retinopathy

Diabetic Retinopathy

- Did you know that diabetes is the most common cause of blindness in individuals from the ages of 25 to 65? And blindness can be caused by multiple different complications associated with diabetes including glaucoma and cataracts, however in this tutorial, let's discuss the most common cause of blindness due to diabetes which is a condition known as diabetic retinopathy. And if we break down the term, we can receive generally, an understanding of what this disease is, so you have retino here meaning the retina, and pathy meaning disease. So, diabetic retinopathy is a disease of the retina that's caused by diabetes. And to describe what the retina is, let's bring in a diagram of the eye and go through some of the structures as it will help us as we learn more about this condition. Over here on the left, we have a cross-section of the eye and there's a few important structures to note. So this is the front of the eye here, and this is the back of the eye, and this part right here is known as the cornea. And it is where light initially passes through as it goes through the eye, and then it hits this structure right here, which is known as the lens. And the lens focuses the light on this structure in the back of the eye, this kind of brownish structure, and this is the retina. And then exiting the back of the eye here, this is the optic nerve. Then, you can also see all of these blood vessels that are traveling through the retina and then exit the back of the eye in the middle of the optic nerve. So if you look over here on the right, this is a front view of the eye. So this is kind of what it looks like when a doctor looks in to your eye. So here, right here we have what's called the optic disc, and the optic disc is really just the convergence of the retina and where it Continue reading >>

What Treatments Are Available For Diabetic Eye Disease?

What Treatments Are Available For Diabetic Eye Disease?

The first step in any treatment for diabetic eye disease is to maintain blood glucose, blood pressure, and blood cholesterol levels as close to normal as possible. Treatment of diabetic macular edema (swelling or the accumulation of blood and fluids in the macula, the part of the retina that provides sharp central vision), has evolved a great deal in the last five to ten years, and is based on the severity of the edema. At present, there are three options: laser treatment Avastin, Lucentis, or Eylea injection intravitreal steroids: Kenalog, Ozurdex, and Iluvien Laser Treatment This technique is used by retinal surgeons to treat a number of eye conditions, one of which is diabetic eye disease. A beam of high-intensity light is directed into the eye to seal off leaking blood vessels and prevent additional blood and fluid from leaking into the vitreous, which is the jelly-like substance that fills the inside of the back part of the eye. The doctor administers eye drops to dilate (open up) the pupil and numb the eye before treatment begins. Because lasers cannot restore lost vision, it is critical to maintain regular comprehensive eye examinations so that treatment can be initiated as soon as diabetic eye changes are detected. There are two types of laser treatments for diabetic eye disease: Focal laser treatment, also called photocoagulation: The retina is treated to stop or slow the leakage of blood and fluid from abnormal blood vessels within the eye. Focal laser, however, can also destroy surrounding healthy retinal tissue as it seals the leakage from abnormal blood vessel growth; therefore, it is not used on blood vessels directly under the macula, the center of the retina. Scatter laser treatment, also called panretinal photocoagulation: The areas of the retina away f Continue reading >>

What Is Diabetic Retinopathy? Is It Reversible?

What Is Diabetic Retinopathy? Is It Reversible?

Diabetic Retinopathy is a disease that mostly people suffering from diabetes come across. It is a medical condition and primarily occurs because diabetes effect the retinas of the eyes and can also lead to blindness. It is usually seen in older people or those who have been suffering from diabetes for a long time now. Its cause is known to be damage in blood vessels of our retinas which happen to make a passage for the blood to seep out of the veins and grow even more fragile and newer blood vessels. With the damage of the blood vessels, the vision of a person gets hampered. He/she might feel changes like blurred vision, blood hemorrhage into the eye and even retinal detachment in severe cases. Diabetic Retinopathy is the most common complication a diabetic has to endure and it needs to be taken seriously. Causes and symptoms of Diabetic Retinopathy The Diabetic Retinopathy is mainly caused by the high blood sugar levels as it can make your eyes weak and damage the blood vessels of retina. You will not experience the adversity of the problem till the advanced stage. The symptoms will be flashing lights or dark spots, sudden vision loss of one eye, blurred vision. You need to contact your ophthalmologist to have a complete examination of your condition. Types of Diabetic Retinopathy It can be classified in 3 types Background diabetic retinopathy – Tiny blood vessels of retinas get damaged. Diabetic maculopathy – Macula endures some damagediabetic “macular oedema” wherein vessels near macula start seeping in fluids on the macula. Proliferative retinopathy – more advanced level of the disease. Wherein newbrittle vessels develop in the retina and the existing ones make a way to fill the back of eyes with a gel like fluid making the dark spots appear in vision. Ris Continue reading >>

Background Diabetic Retinopathy

Background Diabetic Retinopathy

Background diabetic retinopathy or BDR is named appropriately because it sits in the background, not itself a danger to vision, but is instead a warning sign that serious damage may be starting. Directly above the white arrows in the picture are two small flame shaped hemorrhages with tiny microaneurisms seen along either side of the vessel between the arrows. This warning sign is difficult to interpret---80% of people who have had diabetes for over 20 years have some BDR, but only about 1 out of every 4 or 5 of those with BDR will eventually suffer measurable vision impairment. BDR consists of: Microaneurisms: these are usually the earliest visible change in retinopathy seen on exam with an ophthalmoscope as scattered red spots in the retina where tiny, weakened blood vessels have ballooned out. Hemorrhages: bleeding occurs from damaged blood vessels into the retinal layers. This will not affect vision unless the bleeding occurs in or near the Macula. Hard Exudates: caused by proteins and lipids from the blood leaking into the retina through damaged blood vessels. They appear on the ophthalmoscope as hard white or yellow areas, sometimes in a ringlike structure around leaking capillaries. Again vision is not affected unless the macula is involved. BDR is usually picked up on routine eye exams in a doctor's office, or during an exam by an ophthalmologist or optometrist. BDR is an early stage of damage that is visible before vision is endangered and before any symptoms are present. Like "borderline diabetes," it should never be ignored because it signifies that some damage to blood vessels is already underway. Anyone who has BDR can benefit from regular urine tests for microalbumin. The presence of excess microalbumin in the urine identifies people who are 15 times as li Continue reading >>

Diabetic Eye Disease

Diabetic Eye Disease

A A A Do I need to follow-up with my doctor after being diagnosed with diabetic eye disease? Diabetes is one of the leading causes of irreversible blindness worldwide, and, in the United States, it is the most common cause of blindness in people younger than 65 years of age. Diabetic eye disease also encompasses a wide range of other eye problems, for example, Diabetes may cause a reversible, temporary blurring of the vision, or it can cause a severe, permanent loss of vision. Some people may not even realize they have had diabetes for several years until they begin to experience problems with their eyes or vision. Diabetes also may result in heart disease, stroke, kidney failure, and circulatory abnormalities of the legs. The American Diabetes Association estimates that 29.1 million people in the United States have diabetes, and 8.1 million people additional people went undiagnosed. (This population is unaware that they have diabetes.) In the United States 1.2 million new cases of diabetes are diagnosed every year. In the US in 2012, the total annual cost of diagnosed diabetes was 2.45 billion. Eighty-six million people in the US have prediabetes, and 9 out of every 10 don't know they have it. Of the 86 million people with prediabetes, without lifestyle changes 15% to 30% of them will develop type 2 diabetes within 5 years. Lifestyle management has been shown to reduce the risk of developing type 2 diabetes and prediabetes by at least two-thirds. It can also slow or halt the progression of prediabetes to diabetes. People can try to avoid the problems associated with diabetes, including those that affect the eyes, by taking appropriate care of themselves by the following: Maintain a normal level of weight Watch your diet, especially limiting unhealthy types of fats and Continue reading >>

Mechanism Of Diabetic Retinopathy

Mechanism Of Diabetic Retinopathy

The retina Enlarge Light enters the eye from the left in this diagram...shown by the yellow arrow. It passes through the clear jelly of the eye (the vitreous) to reach the retina (pink) Retinopathy is a disease of the retina, occurring in about a quarter of people with diabetes. How does the eye 'work'? Light enters the eye from the front, and passes through the eye to hit the retina, just like in a camera. The retina contains cells that convert the light into the electric signals, and these signals are then sent on to the brain so we can see. Two types of diagram are used in the descriptions in this section about retinopathy. First, a side or 'cut through' view of the eye, like a cut through drawing of a camera as opposite (upper picture). Second, the view the doctor sees when he looks into your eye, like a map, with the blood vessels spreading out from the centre (the optic nerve). The yellow dot is the fovea, where light is focused. The red & blue lines are the larger retinal blood vessels spreading out from the optic nerve. How does the retina work? Light ...in yellow... falls onto the retina. The retinal cells are rods (the long straight cells) and cones (the cells with the pointed end). There are tiny blood vessels (capillaries) on the surface of the retina ...the red ovals enlarge The retinal cells stand next to each other, a bit like houses in a street. The main cells are the rods and cones: these are the cells that take up light and convert it into electrical messages, which are then sent onto the brain. These cells receive their oxygen and other nutrients from tiny blood vessels nearby. These blood vessels are like pipes which pass nearby the cells; imagine a largish pipe passing past your house, containing blood. The walls of these pipes/blood vessels are ver Continue reading >>

Diabetic Retinopathy And Diabetic Macular Edema

Diabetic Retinopathy And Diabetic Macular Edema

Diabetic retinopathy (DR) and diabetic macular edema (DME) are leading causes of blindness in the working-age population of most developed countries. The increasing number of individuals with diabetes worldwide suggests that DR and DME will continue to be major contributors to vision loss and associated functional impairment for years to come. Early detection of retinopathy in individuals with diabetes is critical in preventing visual loss, but current methods of screening fail to identify a sizable number of high-risk patients. The control of diabetes-associated metabolic abnormalities (i.e., hyperglycemia, hyperlipidemia, and hypertension) is also important in preserving visual function because these conditions have been identified as risk factors for both the development and progression of DR/DME. The currently available interventions for DR/DME, laser photocoagulation and vitrectomy, only target advanced stages of disease. Several biochemical mechanisms, including protein kinase C–β activation, increased vascular endothelial growth factor production, oxidative stress, and accumulation of intracellular sorbitol and advanced glycosylation end products, may contribute to the vascular disruptions that characterize DR/DME. The inhibition of these pathways holds the promise of intervention for DR at earlier non–sight-threatening stages. To implement new therapies effectively, more individuals will need to be screened for DR/DME at earlier stages—a process requiring both improved technology and interdisciplinary cooperation among physicians caring for patients with diabetes. CURRENT EPIDEMIOLOGY, NEW PATHOPHYSIOLOGY INSIGHTS, UPDATED DIAGNOSTIC STAGING SYSTEM, RECENT SCREENING TECHNOLOGIES, AND TREATMENT Diabetic retinopathy (DR) and diabetic macular edema (DME) are Continue reading >>

Diabetic Retinopathy: Your Questions Answered

Diabetic Retinopathy: Your Questions Answered

Diabetic retinopathy is a common complication of diabetes and the leading cause of new-onset blindness in American adults. Effective treatments are available to preserve vision for eyes at risk of vision loss from diabetic retinopathy. The most opportune time for these treatments is before any vision has been lost, since even advanced diabetic retinopathy can be present when a person has no vision complaints or problems. What causes diabetic retinopathy? Diabetic retinopathy is caused by changes in the blood vessels of the retina, the thin, light-sensitive inner lining in the back of your eye. These changes are called diabetic retinopathy. How does diabetes damage the vessels in the retina? Elevated levels of blood glucose can damage the body in various ways, including harming the blood vessels in your eyes. Diabetes can affect the lining of the blood vessels in your eyes, causing them to thicken and develop leaks. Poor circulation in the retinal vessels can compound these problems by causing the production of fragile new vessels. What are the stages of retinopathy? Diabetic retinopathy is broadly classified as nonproliferative diabetic retinopathy and proliferative retinopathy. After 20 years of diabetes, most persons with diabetes will shows some signs of nonproliferative diabetic retinopathy, which is generally not sight-threatening itself unless macular edema is present. Proliferative diabetic retinopathy is a more serious stage of retinopathy and poses a greater risk of hemorrhage into the vitreous humor, the clear gel that fills the center of the eye, or detachment of the retina leading to severe vision loss. Diabetic macular edema can occur with either nonproliferative or proliferative diabetic retinopathy. There are various levels of nonproliferative diabetic re Continue reading >>

Blurry Vision And Other Symptoms Of Diabetes

Blurry Vision And Other Symptoms Of Diabetes

Blurry vision is a common symptom of diabetes. Other diabetic symptoms include excessive thirst, frequent urination, weight loss and fatigue. Most of the symptoms are due to the lack of insulin which secondarily allows the sugar levels to sky rocket out of control. This sets up sugar gradients that cause imbalances in water distribution in the body and in different organs. One note, the blurry vision as a symptom of diabetes is not caused by the same mechanism as blurry vision from diabetic retinopathy. “Osmolarity” – Water Follows Sugar The fancy term for this concept is “osmolarity.” One way to think of osmolarity is that sugar attracts water, or, water goes where the sugar goes. Insulin Takes Sugar From the Blood and Delivers it to Your Cells When we eat, food is broken down and absorbed into the bloodstream. The sugars, the little energy units that serve as fuel for our cells, can not get into the cells without insulin. Stated another way, insulin lowers blood sugar. When the supply of insulin is insufficient, as in diabetes, sugar levels in the blood rise. Remember the law of osmolarity, if the sugar stays in the blood, it draws water out and away from your cells and into the bloodstream. Your body becomes dehydrated as the water is drawn into the blood stream. This is a relative increase in the fluid volume of the blood, the kidneys then make more…urine. The relative dehydration also explains the excessive thirst. The frequent urination, and especially, frequent urination at night, are very common symptoms of diabetes. Since the high sugar levels are constantly drawing water out from the cells, the body is constantly dehydrated causing extreme thirst. Weight Loss There are two reasons for the weight loss. One cause is the loss of water weight caused by Continue reading >>

Diabetes And Blurry Vision: What You Need To Know

Diabetes And Blurry Vision: What You Need To Know

Diabetes and blurry vision Diabetes refers to a complex metabolic disease in which your body either can’t produce insulin, doesn’t produce enough insulin, or simply can’t use it efficiently. All your body’s cells need sugar (glucose) for energy. Insulin helps to break down and deliver sugar to cells throughout your body. Sugar levels build up in your blood if you don’t have enough insulin to break it down. This is known as hyperglycemia. Hyperglycemia can negatively affect every part of your body, including your eyes. Blurry vision is often one of the first warning signs of diabetes. Your vision may be blurry because fluid is leaking into the lens of your eye. This makes the lens swell and change shape. Those changes make it hard for your eyes to focus, so things start to look fuzzy. You may also get blurred vision when you start insulin treatment. This is due to shifting fluids, but it generally resolves after a few weeks. For many people, as blood sugar levels stabilize, so does their vision. How can diabetes cause blurry vision? Diabetic retinopathy is a term that describes retinal disorders caused by diabetes. Some of these disorders include macular edema and proliferative retinopathy. Macular edema is when the macula swells due to leaking fluid. The macula is the part of the retina that gives you sharp central vision. Other symptoms of macular edema include wavy vision and color changes. Proliferative retinopathy is when blood vessels leak into the center of your eye. Blurry vision is one of the signs that this is happening. You may also experience spots or floaters, or have trouble with night vision. Blurry vision can also be a symptom of glaucoma, a disease in which pressure in your eye damages the optic nerve. According to the National Eye Institute, i Continue reading >>

Diabetic Retinopathy: Reversibility Of Epigenetic Modifications And New Therapeutic Targets

Diabetic Retinopathy: Reversibility Of Epigenetic Modifications And New Therapeutic Targets

Abstract In recent years, considerable progress has been made in the molecular mechanisms of epigenetics in disease development and progression, the reversible characteristics of epigenetic modification provide new insights for the treatment of such diseases. The pathogenesis of diabetic retinopathy (DR) has not yet been fully understood, treatment of refractory and recurrent diabetic macular edema remains a big change in clinical practice. This review emphasizes that reversibility of epigenetic modification could provide a new strategy for the prevention and treatment of diseases. Background The Human Genome Project found that the protein-coding DNA accounted for only 2% of the entire genome, and thus, proposed that some non-coding regions, such as capable of producing non-coding RNA, repeat fragments, and transposons, may also exercise certain functions. Moreover, the development of some diseases cannot be explained solely by the change in DNA sequence; other factors, including living environment, mental conditions, and stress may also play a vital role in the onset of diseases. Thus, the term epigenetics refers to heritable modifications that are not involved in the changes in the DNA sequence. Epigenetics is also known as “prefix genetics,” “external genetics,” or “post-genetics,” indicating that in the absence of changes in the DNA sequence, the function of genes could undergo changes that are reversible and heritable. Occasionally, it may also refer to the studies on the process of physiological development [1]. Vital mechanisms of epigenetic modification include DNA methylation, histone acetylation, non-coding RNA regulation, and chromatin remodeling. These mechanisms are intrinsically involved in the development of various diseases including cancer, Continue reading >>

Diabetic Retinopathy

Diabetic Retinopathy

Tweet Diabetic retinopathy is the most common form of diabetic eye disease. Diabetic retinopathy usually only affects people who have had diabetes (diagnosed or undiagnosed) for a significant number of years. Retinopathy can affect all diabetics and becomes particularly dangerous, increasing the risk of blindness, if it is left untreated. The risk of developing diabetic retinopathy is known to increase with age as well with less well controlled blood sugar and blood pressure level. According to the NHS, 1,280 new cases of blindness caused by diabetic retinopathy are reported each year in England alone, while a further 4,200 people in the country are thought to be at risk of retinopathy-related vision loss. All people with diabetes should have a dilated eye examination at least once every year to check for diabetic retinopathy. What is diabetic retinopathy? Diabetic retinopathy occurs when changes in blood glucose levels cause changes in retinal blood vessels. In some cases, these vessels will swell up (macular oedema) and leak fluid into the rear of the eye. In other cases, abnormal blood vessels will grow on the surface of the retina. Unless treated, diabetic retinopathy can gradually become more serious and progress from ‘background retinopathy’ to seriously affecting vision and can lead to blindness. Diabetic retinopathy includes 3 different types: What are the symptoms of diabetic retinopathy? Like many conditions of this nature, the early stages of diabetic retinopathy may occur without symptoms and without pain. An actual influence on the vision will not occur until the disease advances. Macular oedema can result from maculopathy and affect vision occurs if leaking fluid causes the macular to swell. New vessels on the retina can prompt bleeding, which can also Continue reading >>

Diabetic Retinopathy

Diabetic Retinopathy

Diabetic retinopathy, also known as diabetic eye disease, is a medical condition in which damage occurs to the retina due to diabetes and is a leading cause of blindness.[1] It affects up to 80 percent of people who have had diabetes for 20 years or more.[2] At least 90% of new cases could be reduced if there were proper treatment and monitoring of the eyes.[3] The longer a person has diabetes, the higher his or her chances of developing diabetic retinopathy.[4] Each year in the United States, diabetic retinopathy accounts for 12% of all new cases of blindness. It is also the leading cause of blindness for people aged 20 to 64 years.[5] Signs and symptoms[edit] Normal vision The same view with diabetic retinopathy. Emptied retinal venules due to arterial branch occlusion in diabetic retinopathy (fluorescein angiography) Diabetic retinopathy often has no early warning signs. Even macular edema, which can cause rapid vision loss, may not have any warning signs for some time. In general, however, a person with macular edema is likely to have blurred vision, making it hard to do things like read or drive. In some cases, the vision will get better or worse during the day. In the first stage which is called non-proliferative diabetic retinopathy (NPDR) there are no symptoms, the signs are not visible to the eye and patients will have 20/20 vision. The only way to detect NPDR is by fundus photography, in which microaneurysms (microscopic blood-filled bulges in the artery walls) can be seen. If there is reduced vision, fluorescein angiography can be done to see the back of the eye. Narrowing or blocked retinal blood vessels can be seen clearly and this is called retinal ischemia (lack of blood flow). Macular edema in which blood vessels leak their contents into the macular regi Continue reading >>

Facts About Diabetic Eye Disease

Facts About Diabetic Eye Disease

Points to Remember Diabetic eye disease comprises a group of eye conditions that affect people with diabetes. These conditions include diabetic retinopathy, diabetic macular edema (DME), cataract, and glaucoma. All forms of diabetic eye disease have the potential to cause severe vision loss and blindness. Diabetic retinopathy involves changes to retinal blood vessels that can cause them to bleed or leak fluid, distorting vision. Diabetic retinopathy is the most common cause of vision loss among people with diabetes and a leading cause of blindness among working-age adults. DME is a consequence of diabetic retinopathy that causes swelling in the area of the retina called the macula. Controlling diabetes—by taking medications as prescribed, staying physically active, and maintaining a healthy diet—can prevent or delay vision loss. Because diabetic retinopathy often goes unnoticed until vision loss occurs, people with diabetes should get a comprehensive dilated eye exam at least once a year. Early detection, timely treatment, and appropriate follow-up care of diabetic eye disease can protect against vision loss. Diabetic retinopathy can be treated with several therapies, used alone or in combination. NEI supports research to develop new therapies for diabetic retinopathy, and to compare the effectiveness of existing therapies for different patient groups. What is diabetic eye disease? Diabetic eye disease can affect many parts of the eye, including the retina, macula, lens and the optic nerve. Diabetic eye disease is a group of eye conditions that can affect people with diabetes. Diabetic retinopathy affects blood vessels in the light-sensitive tissue called the retina that lines the back of the eye. It is the most common cause of vision loss among people with diabetes Continue reading >>

Diabetes And Your Eyes — More Than Retinopathy

Diabetes And Your Eyes — More Than Retinopathy

You probably know that eye damage (retinopathy) is a major complication of diabetes. So when vision blurs, it’s normal to think the worst. But diabetes can cause blurred vision in several other ways, some of which are reversible. I’m embarrassed to admit I only recently found out that blurred vision is a symptom of diabetes, even without any retinal damage. When blood glucose levels go up, blood gets thicker. Thicker blood pulls in more fluid from surrounding tissues, including the lenses of the eye, impacting the ability to focus. -- Keep an eye on your vision! Learn about preventive steps and treatments for diabetic retinopathy from retinal specialist Dr. Charles Wykoff. >> Blood sugar and blurry vision According to WebMD, [Blurred vision] could just be a temporary problem that develops rapidly and is caused by high blood sugar levels. High blood sugar causes the lens of the eye to swell, which changes your ability to see. Changing the shape of the lens naturally throws off vision. This can be a chronic, 24/7 kind of problem, or it can occur only after a high-carb meal, when glucose is way up. The Harvard Medical School Family Health Guide says that after-meal blurriness can be prevented by avoiding high-carb meals. The cure for chronic, all-the-time blurriness is to get blood glucose down to normal range before meals. It may take as long three months of relatively normal blood glucose levels before vision returns to your baseline normal. Diabetes can also cause blurriness or double vision due to hypoglycemia (low blood glucose). In this case, lens shape is probably not to blame. Low blood glucose can make it hard for the brain to focus on what the eye is seeing. Vision usually returns to normal when glucose levels rise. If blurriness doesn’t go away when glucos Continue reading >>

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