Diabetic Retinopathy

Diabetic Retinopathy (The Effect of Diabetes on the Eye)

Diabetic retinopathy is a serious eye disease that develops when the small blood vessels in the retina, located at the back of the eye, are damaged due to diabetes. It is one of the leading causes of vision loss in people with diabetes. However, with early diagnosis, regular retinal check-ups and timely treatment, vision loss can largely be prevented.

Diabetic retinopathy may cause no symptoms at first. For this reason, regular retinal examinations are very important even for diabetic patients whose vision is completely normal.

What Is Diabetic Retinopathy?

The retina is the nerve layer of the eye that detects light and makes vision possible. Persistently high blood sugar over a long period damages the structure of the fine vessels that nourish the retina.

Over time;

• Weakening of the vessel walls,

• Small hemorrhages,

• Fluid leakage,

• Vessel occlusions,

• Formation of new, abnormal vessels in areas deprived of oxygen

may develop.

All of these changes together are called diabetic retinopathy.

Who Gets It?

It can occur in patients with both Type 1 and Type 2 diabetes.

The risk increases in the following situations:

• Long duration of diabetes

• Poorly controlled blood sugar

• High HbA1c level

• Hypertension

• Kidney disease

• High cholesterol

• Smoking

• Pregnancy (in women with diabetes)

The longer a person has diabetes, the higher the likelihood of developing retinopathy.

Symptoms of Diabetic Retinopathy

In the early stage, most patients have no symptoms.

As the disease progresses, the following complaints may occur:

• Blurred vision

• Fluctuating vision

• Decreased vision

• Black floaters in front of the eye

• Dark shadows in the visual field

• Sudden vision loss

• Reduced night vision

Sudden vision loss can often be a sign of intraocular hemorrhage or advanced retinal disease.

Stages of Diabetic Retinopathy

Mild and Moderate Nonproliferative Diabetic Retinopathy

This is the early stage of the disease.

Small hemorrhages and vascular changes are seen in the retina. At this stage, most patients may have normal vision.

The most important treatment is good blood sugar control and regular retinal follow-up.

Severe Nonproliferative Diabetic Retinopathy

Vessel occlusions in the retina increase and the retina cannot receive enough oxygen.

These patients are at high risk of new vessel formation.

Proliferative Diabetic Retinopathy

This is the advanced stage of the disease.

The oxygen-deprived retina forms new but unhealthy vessels.

These vessels;

• Can bleed easily,

• Can cause bleeding inside the eye,

• Can cause traction on the retina,

• Can lead to retinal detachment.

At this stage, it is very important not to delay treatment.

What Is Diabetic Macular Edema?

The macula is the area of the retina responsible for detailed vision.

Diabetes-related vascular leakage can cause fluid to accumulate in the macula.

This condition is called diabetic macular edema.

Diabetic macular edema is one of the most common causes of decreased vision in diabetic patients.

How Is Diabetic Retinopathy Diagnosed?

The diagnosis is made with a detailed retinal examination.

When necessary, the following tests are performed:

• Fundus examination

• OCT (Optical Coherence Tomography)

• OCT Angiography (OCTA)

• Fundus Fluorescein Angiography (FFA)

• Color fundus photography

These examinations make it possible to determine the stage of the disease and the most appropriate treatment method.

How Is Diabetic Retinopathy Treated?

Treatment is planned according to the stage of the disease.

Blood Sugar Control

Good diabetes control is the foundation of successful treatment.

Keeping blood sugar, HbA1c, blood pressure and cholesterol levels under control slows the progression of the disease.

Intravitreal Injections

This is the most commonly used treatment method for diabetic macular edema and some advanced retinal diseases.

Anti-VEGF drugs or, in suitable patients, corticosteroid-containing drugs are injected into the eye to reduce edema and preserve vision.

The treatment is often repeated at certain intervals.

Retinal Laser Treatment

Panretinal photocoagulation (PRP) laser treatment, applied especially in proliferative diabetic retinopathy, aims to reduce new vessel formation and prevent serious complications.

In some patients, laser treatment may be combined with intravitreal injections.

Vitrectomy Surgery

In advanced diabetic retinopathy, when;

• Dense intraocular hemorrhage,

• Traction on the retina,

• Tractional retinal detachment,

develop, vitrectomy surgery may be necessary.

During surgery, the blood inside the eye is cleared, membranes are peeled and the retina is restored as closely as possible to its normal anatomical structure.

Is It Possible to Prevent Diabetic Retinopathy?

Yes.

Although complete prevention is not always possible, the risk can be significantly reduced.

To achieve this:

• Blood sugar should be well controlled.

• HbA1c should be kept at target levels.

• Blood pressure and cholesterol should be controlled.

• Smoking should be stopped.

• Regular exercise should be done.

• Retinal check-ups should not be skipped.

How Often Should Diabetic Patients Have a Retinal Examination?

Everyone diagnosed with diabetes should have regular retinal examinations, even if their vision is normal.

For patients without retinopathy, a retinal check-up at least once a year is usually recommended. For patients who have developed retinopathy, the frequency of check-ups is determined by the retina specialist according to the stage of the disease.

Conclusion

Diabetic retinopathy is one of the most important eye complications of diabetes. The disease may not cause symptoms in its early stages, but it can be diagnosed early thanks to regular retinal examinations. Today, with modern methods such as OCT, intravitreal injections, retinal laser treatment and vitrectomy surgery, vision can be preserved in many patients and serious vision loss can be prevented.

At Kaşkaloğlu Eye Hospital, the diagnosis and treatment of diabetic retinopathy are carried out by experienced retina specialists under the leadership of Prof. Dr. Mahmut Kaşkaloğlu. Our hospital offers patients up-to-date, personalized treatment options with advanced retinal imaging systems, modern laser technologies, intravitreal injection treatments and vitrectomy surgery.