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Diabetic Retinopathy: How does Diabetes Influence the Retina?

Dr. Pravin Jain In Retina

Jun 26, 2023 | 4 min read

It is estimated that more than 30 million individuals in India live with diabetes, and roughly 7.7 million of them have diabetic retinopathy, making it the most widely recognized reason for vision impairment in adults. The predominance of diabetic retinopathy has expanded essentially in the course of recent years, because of the ascent in the quantity of individuals determined to have diabetes.

How does Diabetes Influence the Retina?

The retina is the light-detecting part situated in the rear of the eye. It consists of nerve cells (neurons), specific cells called photoreceptors that are associated with directly detecting light and blood vessels. The ability of the retina to detect light requires energy, which is subject to the oxygen provided by blood flowing through the vessels.

In diabetes, increased glucose levels harm the vessels of the retina. These harmed vessels release fluid, leak blood, and don’t provide sufficient oxygen to the retina, prompting retinal ischemia. Subsequently, retinal cells start to die and the retina doesn’t work as expected.

Moreover, diabetes additionally harms the neuron of the retina directly. Together, these impacts cause diabetic retinopathy.

Vision impairment related to diabetic retinopathy may at first influence focal vision because of a condition called diabetic macular edema. This fluid collection on the macula, a part of the retina responsible for sharp, focal vision, can prompt foggy vision and contortion of pictures.

Advanced diabetic retinopathy entails the development of irregular vessels that may bleed within the eye, resulting in a sudden vision loss. This results in an abrupt, drape-like vision impairment as blood collects within the eye. Further deterioration of advanced diabetic retinopathy can prompt retinal detachment, which requires critical careful mediation and can bring about long-lasting, irreversible vision impairment if not expeditiously treated.

How Can You Forestall Diabetic Retinopathy?

The Indian Diabetes Association suggests that people with diabetes should keep their HbA1c level (a proportion of normal glucose levels over the past few months) beneath 7% to forestall the danger of complexities. As blood glucose straightforwardly harms retinal vessels, there is solid epidemiological proof that glucose control means diminished occurrence and seriousness of diabetic retinopathy.

To reduce cardiovascular and microvascular complications of diabetes, including retinopathy, nephropathy (kidney disease), and neuropathy (nerve damage), experts recommend individuals to maintain normal blood pressure. Pulse decrease can defer the beginning of diabetic retinopathy, yet it is unclear if controlling blood pressure can modify the direction of the setup of diabetic retinopathy. Also, keeping the cholesterol controlled helps in overall diabetes management, yet it isn’t evident whether doing so diminishes the danger of diabetic retinopathy.

How Can I Figure Out If I Have Diabetic Retinopathy?

An ophthalmologist can analyze and initiate treatment for diabetic retinopathy before vision is impacted. Medical guidelines advise individuals with type 1 diabetes to schedule an annual ophthalmologist visit, starting five years after diabetes diagnosis. Individuals with type 2 diabetes should see an ophthalmologist for a retinal assessment as early as possible after the diagnosis of diabetes and afterward plan yearly tests. You might have to see an ophthalmologist as often as possible in case you are pregnant or have further developed this condition.

What can I do to prevent or slow down vision loss if I have diabetic retinopathy?

As referenced above, harm to the vessels deprives the retina of oxygen. A deficiency of oxygen leads to the creation of a signal protein called vascular endothelial growth factor (VEGF). Right now, there are medications that can bind VEGF and accordingly work on preventing the harmful effects of VEGF causing diabetic retinopathy. Ophthalmologists directly infuse these “anti-VEGF” specialists into the eye, leading to improvements in diabetic macular edema and potential reduction in the severity of diabetic retinopathy.

In certain individuals, steroids infused straightforwardly into the eye may likewise improve diabetic macular edema. In some high-level instances of proliferative diabetic retinopathy (the most progressive type of diabetic retinopathy), patients might require retinal laser treatment or retinal medical procedure to stop or slow bleeding and spillage, to recoil harmed vessels and to eliminate blood and scar tissue helping in vision restoration.

Regular eye checkups and strict blood sugar level control are monumental in preventing the development and progression of diabetic retinopathy.

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Written and Verified by:

Dr. Pravin Jain

Dr. Pravin Jain

MBBS, DNB, MNAMS, FVRS, FCF, & FICO

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