Hypertensive Diabetic Retinopathy

Stages and Symptoms

A fortunate aspect of diabetic retinopathy is that this condition typically does not develop until a person has had diabetes for 3 to 5 years or more. Not every person with diabetes will develop diabetic retinopathy. In early stages, it is not necessarily require having any symptoms but as the condition progress slowly or quickly, depends upon several factors including patient’s blood sugar, cholesterol and blood pressure, may experience condition as mention below:

Mild Non-Proliferative Retinopathy:

It is the early stage of Diabetic retinopathy where tiny bulges so called micro-aneurysms, in the retina’s blood vessels to leak small amount of blood into the retina. This leakage can lead to swelling in the macula causing blurred vision. Since NPDR, is the early stage where symptoms might be mild or non-existent.

Moderate Non-Proliferative Retinopathy:

In this stage, the disease progresses, some of the tiny blood vessels that are nourishing the retina become blocked which further causes an accumulation of blood and other fluids in the macula.

Severe Non-Proliferative Retinopathy:

In this stage, the disease has progress further, and substantially the tiny blood vessels are blocked, depriving several areas of the retina with their blood supply. These areas of retina send signal to the body to grow new blood vessels for nourishment.

Proliferative Retinopathy:

At this advanced stage, the signals sent by the retina for nourishment trigger the growth of new blood vessels. This condition is called proliferative retinopathy. These new blood vessels are weak, abnormal and fragile. These new vessel sit near the vitreous get at the center of the eye. Being that they do not grow normally, these blood vessels may leak blood into the eye, causing severe vision loss or even can cause permanent blindness.

A comprehensive eye examination by an eye specialist or Ophthalmologist can detect diabetic retinopathy in its earlier stages, before symptoms become apparent.

• Blurred or patchy vision
• Eye floaters (shapes floating in your vision)
• Impaired color vision
• Poor night vision
• A sudden or total loss of vision

Risk Factors:

• Anybody with diabetes is at risk of developing diabetic retinopathy. However, the risk is higher if the person:
• People with high blood glucose level have an increased risk of diabetic retinopathy
• People suffering from different kidney disease are highly exposed to an increased risk of diabetic retinopathy
• People with high blood pressure have an increased risk of diabetic retinopathy
• People with high cholesterol have an increased risk of diabetic retinopathy
• People who are overweight have an increased risk of diabetic retinopathy
• People who smoke regularly are also highly exposed to increased risk of diabetic retinopathy
• Women who are pregnant are associated with increased risk of development and progression of diabetic retinopathy

Treatment

Most important is to understand and prevent to some extent by taking care of Risk Factors. Diabetic retinopathy depends largely on the type of diabetic retinopathy one have and how severe it is.

Treatments in the early stage can be prevented very well and easier to treat and more likely that vision will be saved. It starts with controlling blood sugar and blood cholesterol (diabetes) within a healthy range. Taking diabetes medication as directed, managing diets and regular maintaining physical activities.

Laser Surgery:

Laser surgery is often recommended for people with Macula. The main goal of treatment is to prevent further loss of vision or a worsening of your condition.

Focal Laser Therapy – stop or slow blood and fluid leaking in the eye. Abnormal blood vessels are treated with laser burn.

Scatter Laser (Panretinal Photocoagulation) – reduces the drive for abnormal blood vessels and swelling in the retina.

Eye Medications:

A steroid injection in the eye can stop inflammation and prevent the formation of new blood vessels. Medication (anti-VEGF) injected into the eyes may be recommended which can reduce swelling in the macula and improve vision.

Vitrectomy:

Laser Surgery does not cure diabetic retinopathy and does not always prevent further loss of vision. Hence, further treatment, Eye Surgery is required.

Vitrectomy Surgery is an eye surgery required when patient have Proliferative Diabetic Retinopathy where disease is so advance and laser treatment alone cannot remove blood and scar tissue.

This surgery treats problems with the retina and vitreous, a jellylike substance in the middle of the eye. The surgery can remove scar tissue, blood or fluid, and some of the vitreous gel so light rays can focus properly on the retina. At the same time, traction in the retina or retinal detachments can be corrected.