Laser Treatment Of Diabetic Retinopathy
Laser photocoagulation is a proven effective treatment for preserving vision and reducing the risk of vision loss from diabetic retinopathy. Pioneered by Drs. Lloyd M. Aiello and William P. Beetham in the late 1960s using a ruby laser, scatter (or panretinal) laser photocoagulation reduces the risk of severe vision loss by 60% or more. In national clinical trials of laser treatment for diabetic retinopathy conducted at multiple locations, laser photocoagulation reduced the risk of severe vision loss from diabetic retinopathy to less than 2% over a five-year period. More than 3,700 patients participated in this Early Treatment Diabetic Retinopathy Study, which was chaired by Dr. Lloyd M. Aiello. The Beetham Eye Institute was the largest clinical center in this study, enrolling more than 250 patients. This study also showed that focal laser photocoagulation reduces the risk of vision loss from macular edema by 50% or more. Two laser techniques are performed today, generally using an argon laser: --Scatter or panretinal photocoagulation generally requires 1,200-1,800 individual laser spots, usually spread over two or three sessions. In this technique the ophthalmologist avoids the macula, the central area of the retina that is responsible for our reading vision, color vision, and other tasks requiring sharp vision. Scatter laser photocoagulation is used to treat proliferative diabetic retinopathy, a major cause of severe vision loss from diabetes. --Focal laser surgery uses fewer spots and less intense laser power to treat diabetic macular edema. Using a technique called fluorescein angiography and other examination and photographic techniques, the ophthalmologist identifies areas that are leaking fluid into the macula area. These areas are then treated directly with a las Continue reading >>
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. It affects up to 80 percent of people who have had diabetes for 20 years or more. At least 90% of new cases could be reduced if there were proper treatment and monitoring of the eyes. The longer a person has diabetes, the higher his or her chances of developing diabetic retinopathy. 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. Signs and symptoms 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 >>
Diabetic RetinaScreen is a new, government-funded screening programme, offering free, regular diabetic retinopathy screening to people with diabetes aged 12 and over. Diabetic retinopathy is a common complication of diabetes which affects the small blood vessels in the lining at the back of the eye. This lining is called the retina. The retina helps to change what you see into messages that travel along the sight nerve to the brain. A healthy retina is necessary for good eyesight. Diabetic retinopathy can cause the blood vessels in the retina to leak or become blocked and damage your sight. In the early stages, diabetic retinopathy will not affect the sight, but if the changes get worse, eventually the sight will be affected. The categories of retinopathy are: Background retinopathy Background retinopathy occurs in the early stages and damage is limited to tiny bulges (microaneurysms) in the blood vessel walls. Although these can leak blood and fluid they do not usually affect vision. Pre-proliferative diabetic retinopathy is detected This is where there are changes detected in the retina that do not require treatment but need to be monitored closely as there is a risk that they may progress and affect the eyesight. A referral will be made to an Ophthalmology Clinic. It is important that you attend this appointment. Proliferative diabetic retinopathy Proliferative diabetic retinopathy occurs where fragile new blood vessels form on the surface of the retina over time. These abnormal vessels can bleed or develop scar tissue causing severe loss of sight. Diabetic macular oedema Diabetic macular oedema occurs where leaky blood vessels affect the part of the retina called the macula. If fluid leaks from these vessels and affects the centre of the macula, the sight will be af Continue reading >>
What Is Diabetic Retinopathy?
People with diabetes can have an eye disease called diabetic retinopathy. This is when high blood sugar levels cause damage to blood vessels in the retina. These blood vessels can swell and leak. Or they can close, stopping blood from passing through. Sometimes abnormal new blood vessels grow on the retina. All of these changes can steal your vision. Stages of diabetic eye disease There are two main stages of diabetic eye disease. NPDR (non-proliferative diabetic retinopathy) This is the early stage of diabetic eye disease. Many people with diabetes have it. With NPDR, tiny blood vessels leak, making the retina swell. When the macula swells, it is called macular edema. This is the most common reason why people with diabetes lose their vision. Also with NPDR, blood vessels in the retina can close off. This is called macular ischemia. When that happens, blood cannot reach the macula. Sometimes tiny particles called exudates can form in the retina. These can affect your vision too. If you have NPDR, your vision will be blurry. PDR (proliferative diabetic retinopathy) PDR is the more advanced stage of diabetic eye disease. It happens when the retina starts growing new blood vessels. This is called neovascularization. These fragile new vessels often bleed into the vitreous. If they only bleed a little, you might see a few dark floaters. If they bleed a lot, it might block all vision. These new blood vessels can form scar tissue. Scar tissue can cause problems with the macula or lead to a detached retina. PDR is very serious, and can steal both your central and peripheral (side) vision. Continue reading >>
What Is It? Retinopathy means that disease has damaged the retina. The retina is the part inside the eye that senses light. Different diseases can cause retinopathy. There can be partial or complete loss of vision. Retinopathy can develop slowly or suddenly, can get better on its own or lead to permanent damage. The retina contains many blood vessels. Abnormalities in these vessels are a major cause of retinopathy. There are several types of retinopathy, including: Retinopathy of prematurity (ROP). ROP occurs in some infants who are born prematurely or at a low birth weight. When a child is born too early, retinal blood vessels do not have time to finish growing properly. In the early stages of ROP, there are only subtle changes and no obvious symptoms. In more advanced stages, the retina can become detached, causing blindness. Diabetic retinopathy. Diabetic retinopathy develops in people with type 1 or type 2 diabetes. It takes years to develop. Two kinds of diabetic retinopathy have the potential to diminish vision: In nonproliferative retinopathy, blood vessels in the retina deteriorate. Deteriorating blood vessels can become blocked or deformed. Fluids, fats and proteins leak out of the abnormal blood vessels. Fluid can collect in the retina. This swelling impairs sharp vision. In proliferative retinopathy, new, structurally unstable blood vessels grow on the surface of the retina. These unstable blood vessels cause frequent minor bleeding. The bleeding causes local irritation and scarring. Proliferative retinopathy can cause retinal detachment. This is a separation of the layers of the retina. It is one of the most serious consequences of proliferative retinopathy. The vitreous is the clear gel between the lens and the retina. Sudden bleeding into the vitreous can Continue reading >>
Diabetic retinopathy is a condition that occurs in people who have diabetes. It causes progressive damage to the retina, the light-sensitive lining at the back of the eye. Diabetic retinopathy is a serious sight-threatening complication of diabetes. Diabetes interferes with the body's ability to use and store sugar (glucose). The disease is characterized by too much sugar in the blood, which can cause damage throughout the body, including the eyes. Over time, diabetes damages the blood vessels in the retina. Diabetic retinopathy occurs when these tiny blood vessels leak blood and other fluids. This causes the retinal tissue to swell, resulting in cloudy or blurred vision. The condition usually affects both eyes. The longer a person has diabetes, the more likely they will develop diabetic retinopathy. If left untreated, diabetic retinopathy can cause blindness. Symptoms of diabetic retinopathy include: Seeing spots or floaters Blurred vision Having a dark or empty spot in the center of your vision Difficulty seeing well at night When people with diabetes experience long periods of high blood sugar, fluid can accumulate in the lens inside the eye that controls focusing. This changes the curvature of the lens, leading to blurred vision. However, once blood sugar levels are controlled, blurred distance vision will improve. Patients with diabetes who can better control their blood sugar levels will slow the onset and progression of diabetic retinopathy. Often the early stages of diabetic retinopathy have no visual symptoms. That is why the American Optometric Association recommends that everyone with diabetes have a comprehensive dilated eye examination once a year. Early detection and treatment can limit the potential for significant vision loss from diabetic retinopathy. T Continue reading >>
The Facts Retinopathy refers to damage to the blood vessels of the retina. The retina, at the back of the eye, provides a window to the circulatory system. By examining it, a doctor can inspect a sample of the body's blood vessels and detect early signs of complications of diabetes or high blood pressure, as well as many other diseases (e.g., sickle cell disease, anemia, lupus). Retinopathy can also be seen in premature newborns. Some of the kinds of damage that your doctor may see in your retina are hypertensive retinopathy, a complication of high blood pressure (hypertension), and diabetic retinopathy, a complication of long-term diabetes. It's unusual for hypertension to impair vision, but hypertensive retinopathy can lead to blockage of retinal arteries or veins, which in turn may eventually result in the loss of vision. Smoking and diabetes increase the risk of developing hypertensive retinopathy. Diabetic retinopathy is a deterioration of the blood vessels in the retina that usually affects both eyes. It is the leading cause of blindness in North America. Almost all people with diabetes show signs of retinal damage after about 20 years of living with the condition. Causes Retinopathy is usually a sign of another medical condition. Although several medical conditions (e.g., sickle cell disease, lupus) can cause retinopathy, the most common causes are diabetes and hypertension (high blood pressure). Diabetic retinopathy is a complication of diabetes. Diabetes causes high blood sugar levels, which can damage blood vessels. The damaged vessels around the retina can leak protein and fats, forming deposits that can interfere with vision. The damaged blood vessels are also not as effective at carrying oxygen to the retina, which can also cause damage. In the advanced sta Continue reading >>
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 >>
What Causes Diabetes?
Little Known Factors That Lead To Diabetes What are some of the lifestyle, genetics and other not-so-obvious factors that can trigger diabetes? What can you do to prevent this condition? Diabetes is a chronic condition associated with abnormally high levels of sugar (glucose) in the blood. It affects over 29.1 million people in the U.S. – 9.3 percent of the population in the U.S. Another 86 million Americans have prediabetes and aren’t even aware of it. The cause of diabetes is the absence or insufficient production of the hormone insulin, which lowers blood sugar in the body. Two types of diabetes There are two types of diabetes: type 1 and type 2, which are also known as insulin-dependent and non-insulin-dependent diabetes. Type 1 diabetes is less common: it affects only 1 in 250 Americans and only occurs in individuals younger than age 20. It has no known cure. A majority of type 2 diabetes cases can be prevented or cured. Signs and symptoms Among the symptoms of type 1 and type 2 diabetes are: Increased urine Excessive thirst Weight loss Hunger Fatigue Skin problems Slow-healing wounds Yeast infections Tingling or numbness in feet or toes Various factors Research has proven that there are certain lifestyle and genetic factors that lead to diabetes. Among them are: Leading a non-active lifestyle A family history of diabetes High blood pressure (hypertension) Low levels of the good cholesterol (HDL) Elevated levels of triglycerides (a type of fat) in the blood Increasing age Polycystic ovary syndrome Impaired glucose tolerance Insulin resistance Gestational diabetes during a pregnancy Some ethnic backgrounds (African Americans, Hispanic/Latino Americans, Asian Americans, Pacific Islanders, Native Americans and Alaska natives) are at greater risk of diabetes. Get t Continue reading >>
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 >>
What is diabetic retinopathy? Diabetic retinopathy is an eye condition that affects the retinas of people with diabetes. It is caused by changes in the blood vessels of the eye and occurs as a result of high blood sugar (glucose) that people with diabetes have over a long period of time. The retina is a light-sensitive nerve tissue at the back of the eye. The retina converts the light rays that enter the eye into electrical impulses that travel along the optic nerve to the brain. Too much blood glucose can destroy the blood vessels in the back of the eye, preventing the retina from receiving the proper amount of nutrients it needs to maintain vision. Diabetic retinopathy occurs when diabetes damages the tiny blood vessels in the retina. In the early stages of the disease (nonproliferative retinopathy), these blood vessels leak fluid and distort sight. In the more advanced stage (proliferative retinopathy), fragile new blood vessels grow around the retina and in the vitreous humor (a clear substance inside the eye). If these blood vessels are not treated, they may bleed and blur vision, or may scar and detach (disconnect) the retina. Anyone with diabetes (Type 1 or Type 2) is at risk of developing diabetic retinopathy. The factors that affect risk include: The type of diabetes a person has (Type 1 or 2); How well-controlled the blood glucose is; and, How long a person has had diabetes. What are the symptoms of diabetic retinopathy? Usually, there are no symptoms of early diabetic retinopathy, and the person’s sight may not be affected until the condition is severe. Symptoms of diabetic retinopathy include: The loss of central vision, for example, when reading or driving; Loss of the ability to see color; Blurred or distorted vision; Small spots (floaters). Because reti Continue reading >>
Practice Essentials Diabetes mellitus (DM) is a major medical problem throughout the world. Diabetes causes an array of long-term systemic complications that have considerable impact on the patient as well as society, as the disease typically affects individuals in their most productive years.  An increasing prevalence of diabetes is occurring throughout the world.  In addition, this increase appears to be greater in developing countries. The etiology of this increase involves changes in diet, with higher fat intake, sedentary lifestyle changes, and decreased physical activity. [3, 4] Patients with diabetes often develop ophthalmic complications, such as corneal abnormalities, glaucoma, iris neovascularization, cataracts, and neuropathies. The most common and potentially most blinding of these complications, however, is diabetic retinopathy, [5, 6, 7] which is, in fact, the leading cause of new blindness in persons aged 25-74 years in the United States. Approximately 700,000 persons in the United States have proliferative diabetic retinopathy, with an annual incidence of 65,000. An estimate of the prevalence of diabetic retinopathy in the United States showed a high prevalence of 28.5% among those with diabetes aged 40 years or older.  (See Epidemiology.) The exact mechanism by which diabetes causes retinopathy remains unclear, but several theories have been postulated to explain the typical course and history of the disease. [9, 10] See the image below. In the initial stages of diabetic retinopathy, patients are generally asymptomatic, but in more advanced stages of the disease patients may experience symptoms that include floaters, distortion, and/or blurred vision. Microaneurysms are the earliest clinical sign of diabetic retinopathy. (See Clinical Presentat Continue reading >>
Diabetic retinopathy develops in stages over time. If you're diagnosed with diabetic retinopathy after diabetic eye screening, lifestyle changes and/or treatment can reduce the chances of the problem progressing. The main stages of diabetic retinopathy are described below. You won’t necessarily experience all of these. Stage one: background retinopathy This means that tiny bulges (microaneurysms) have appeared in the blood vessels in the back of your eyes (retina), which may leak small amounts of blood. This is very common in people with diabetes. At this stage: your sight isn't affected, although you're at a higher risk of developing vision problems in the future you don't need treatment, but you'll need to take care to prevent the problem getting worse – read more about preventing diabetic retinopathy the chances of it progressing to the stages below within three years is over 25% if both of your eyes are affected Stage two: pre-proliferative retinopathy This means that more severe and widespread changes are seen in the retina, including bleeding into the retina. At this stage: there's a high risk that your vision could eventually be affected you'll usually be advised to have more frequent screening appointments every three or six months to monitor your eyes Stage three: proliferative retinopathy This means that new blood vessels and scar tissue have formed on your retina, which can cause significant bleeding and lead to retinal detachment (where the retina pulls away from the back of the eye). At this stage: there's a very high risk you could lose your vision treatment will be offered to stabilise your vision as much as possible, although it won't be possible to restore any vision you've lost Diabetic maculopathy In some cases, the blood vessels in the part of th Continue reading >>
Diabetic Retinopathy: A Leading Cause Of Blindness
Following closely behind glaucoma and macular degeneration, diabetic retinopathy is one of the leading causes of blindness in the United States. What is Diabetic Retinopathy? Diabetic retinopathy is the most common diabetic eye condition and is caused by changes in the blood vessels of the retina. It’s important to recognize the signs and stages of the disease so you can treat it before your vision worsens. Diabetic Retinopathy Stages Alexander Anetakis, MD, a retina specialist at the UPMC Eye Center, discusses the two common types or stages of diabetic retinopathy: Nonproliferative retinopathy Proliferative retinopathy Nonproliferative Retinopathy In the earliest stage of the disease, blood vessels in the retina may become swollen and leak fluid and small amounts of blood into the eye. As the diabetic retinopathy progresses, blood vessels begin to block the blood supply to the retina. Often there are no symptoms of diabetic retinopathy or the symptoms are minor. Proliferative Retinopathy In the most advanced stage of diabetic retinopathy, signals are sent to the body to grow more blood vessels in an attempt to restore the blood supply. These new blood vessels are fragile and abnormal. The walls of these new blood vessels are thin and fragile and as a result do not supply the retina with proper blood flow. These thin blood cells may begin to leak blood, which results in severe vision loss and blindness. Macular Edema At any stage of the disease, macular edema can occur. When this happens, fluid leaks into the macula, the small area at the center of your retina. The macula is the section of your retina that is responsible for sharp vision. With the addition of fluid, the macula becomes swollen and ultimately blurs vision. Diabetic Retinopathy Symptoms Like most conditi Continue reading >>
What Is Diabetic Retinopathy?
Diabetic retinopathy (DR) is a form of eye disease caused by the chronically high blood sugar that's associated with diabetes. It occurs as a result of damage to the blood vessels in the retina, the area of light-sensitive tissue in the back of the eye. Prevalence According to the Centers for Disease Control and Prevention (CDC), an estimated 4.1 million Americans have some form of retinopathy. Nearly one in four of these people suffer from vision-threatening forms of the disease. The National Eye Institute reports that DR is the most common cause of vision loss among people with diabetes, as well as the leading cause of vision impairment and blindness among working adults between ages 20 and 74. Types of Retinopathy Although diabetic retinopathy — caused by chronic high blood sugar — is the most common form of retinopathy, there are several other types. All forms of the disease are associated with damage to the blood vessels in the retina. Other forms of retinopathy include: Hypertensive retinopathy (damage caused by high blood pressure) Arteriosclerotic retinopathy (caused by atherosclerosis, hardening or thickening of the arteries) Retinopathy of prematurity (occurs in underweight, premature babies) Diabetic Retinopathy Symptoms DR progresses through four stages, each of which is associated with different symptoms. In the early stages, DR often does not have noticeable symptoms, so the disease often goes undetected until it affects vision. Bleeding from damaged blood vessels in the retina can cause you to see "floaters," or spots that appear across your field of vision. Floaters sometimes clear on their own. But if you experience floaters and have one of the underlying conditions that can cause retinopathy, check with your doctor. The stages of diabetic retinopat Continue reading >>