Diabetic retinopathy is a term used to describe consequences of abnormalities in the blood vessels of the retina that occur in diabetes. There are basically two forms of diabetic retinopathy, “Background” and “Proliferative.”
Background diabetic retinopathy by far is the most common and least severe form. It involves bleeding within the various layers of the retina (hemorrhages) and leakage of serum into the retina, which results in protein deposits called “exudates”. This form of retinopathy typically does not cause any vision loss, but may be a precursor to proliferative retinopathy. Should fluid leak into the central retina called the “macula”, then central vision is threatened. This condition is termed diabetic macula edema.
Proliferative diabetic retinopathy occurs when the retina is not receiving enough oxygen due to the severity of the background retinopathy. In response to this inadequate level of retinal oxygenation (or “hypoxia”) a vasoactive substance is produced which stimulates the production of new retinal vessels called “neovascular vessels”. These new vessels are very fragile and tend to bleed and leak profusely. Severe bleeds can enter the vitreous or pre-retina space and severely effect vision. These large bleeds may require surgery to remove the blood. Over time the new vessels form fibrous connective tissue bands that create traction to the retina and can lead to a very special form of retinal detachment.
Get Treatment From Our Diabetic Retinopathy Specialist In Fort Lauderdale, FL
Although some complications of diabetic eye disease cause symptoms, many do not, especially in their early phases. There are very specific clinical findings that indicate the need for treatment. A detailed retinal examination by your doctors at Broward Eye Care will determine your condition and treatment.
The most critical aspect of treatment for diabetic eye complications involves the tight control of the disease itself. This relates to tight control of blood sugar levels, weight, and blood pressure. This is crucial in the prevention of ocular complications in diabetes as well as in slowing the progression of the disease.
Laser retinal therapy is the mainstay of specific treatment for diabetic retinopathy. Laser therapy is used in one of two ways for retinopathy. First focal laser treatment is used to seal specific areas of blood vessel leakage. This is especially useful if macula edema is due to a localized area of leakage.
Occasionally the macula edema is more diffuse and a “grid pattern” of laser is used. In cases of proliferative diabetic retinopathy a form of laser therapy known as “pan retinal photocoagulation” (PRP) is used. In this case large areas of under-oxygenated retina are treated with a scatter of many laser burns. The destruction of this already damaged retina reduces the oxygen demand of the retina as a whole, thus reducing the stimulus to create new fragile neovascular vessels.
PRP is destructive in nature and not intended to improve vision per se. The goal of PRP is to prevent further vision loss and potentially blinding complications of diabetic retinopathy. Following PRP there can be some loss of side vision and color vision in some cases. All laser treatments for diabetic retinopathy are performed as an outpatient procedure and do not require hospitalization.
Vitrectomy surgery is a complex eye operation that is used to remove persistent vitreous hemorrhage and to treat tractional retinal detachments. It is only performed by highly specialized retinal specialists and is done in the hospital.