It is a secondary disease caused by diabetes, and it is the main cause of severe vision damage in people under the age of 60 in the Western world. The longer diabetes lasts, the higher the risk of developing diabetic retinopathy, and the longer diabetes persists for a longer time, the more severe the disease will be.
Signs of diabetic retinopathy often begin at least five years after diabetes is discovered. After 20 years of diabetes, about 90% of patients have some degree of diabetic retinopathy.
There are two forms of diabetic retinopathy: the easiest one, which is called Background Diabetic Retinopathy, which is also known as “Non-proliferative Diabetic Retinopathy”, while the more difficult and advanced picture is proliferative diabetic retinopathy.
Diabetic retinopathy is characterized by a number of changes, the most important of which are:
1. Damage to the small blood vessels in the retina
2. Changes in the endothelium and increase its permeability
3. Leakage of fluids and blood components
4. Blockage of small blood vessels in the retina
5. Lack of blood supply and lack of proper oxygenation in the tissues
6. Bleeding inside the retina
Methods of treating diabetic retina:
Laser therapy One of the well-known treatments for diabetic retinopathy is laser therapy. The need for treatment is determined by clinical examination and not on the basis of visual acuity. The goal of diabetic retina therapy is to prevent leakage of blood fluids and absorb the edema that has formed as a result of stopping the leakage, which allows maintaining a healthy vision according to the patient’s initial visual acuity.
In 10% of cases, diabetic retina treatment not only preserves vision, but also improves vision. Laser therapy has been found to reduce the risk of moderate vision reduction by about 50%.
Steroid injections. There are cases of chronic macular edema, which also does not improve after several laser treatments. In these cases, steroids may be injected into the vitreous eye socket to reduce leakage from blood vessels and help absorb edema. Surgical intervention. Another possible curative surgery is vitrectomy. This surgery may help reduce leakage from blood vessels in the vitreous cavity.
Retina treatment for the most difficult diabetic patients: proliferative diabetic retinopathy. In this type of diabetic retinopathy, there is an increase in new blood vessels that grow on the retina or from the retina into the vitreous cavity. The principle of laser therapy for the proliferative form differs in the proliferative form from the non-proliferative form: when the disease is in its proliferative form, the retina is treated for diabetics in every area of the peripheral retina. There is no choice but to infect large areas in the periphery, and practically “sacrifice” the vision in the surrounding areas, in order to preserve the central visual field, namely, the spot. The goal of treatment is to mask – the new blood vessels that have grown, as well as prevent their reproduction.
It is important to remember and understand well that the risk of vision loss at an early age can be reduced, by means of preventive treatment. Therefore, it is important to ensure that blood sugar levels are balanced along with continuous follow-up.