Diabetic Retinopathy (RD) is a condition occurring in persons with diabetes, which causes progressive damage to the retina, the light sensitive lining at the back of the eye. It is a serious sight-threatening complication of diabetes.

Risk Factors: 

• Diabete
• Race
• Other medical conditions: high blood pressure, high blood cholesterol
• Obesity
• Pregnancy

Diabetic Retinopathy is classified into 2 types:

• Non-proliferative diabetic retinopathy (NPDR) is the early state of the disease in which symptoms will be mild or non-existent. In NPDR, the blood vessels in the retina are weakened causing tiny bulges called microanuerysms to protrude from their walls. The microanuerysms may leak fluid into the retina, which may lead to swelling of the macula.
• Proliferative diabetic retinopathy (PDR) is the more advanced form of the disease. At this stage, circulation problems cause the retina to become oxygen deprived. As a result new fragile blood vessels can begin to grow in the retina and into the vitreous, the gel-like fluid that fills the back of the eye. The new blood vessel may leak blood into the vitreous, clouding vision. Other complications of PDR include detachment of the retina due to scar tissue formation and the development of glaucoma. Glaucoma is an eye disease defined as progressive damage to the optic nerve. In cases of proliferative diabetic retinopathy, the cause of this nerve damage is due to extremely high pressure in the eye. If left untreated, proliferative diabetic retinopathy can cause severe vision loss and even blindness.

Signs and Symptoms:

• Seeing spots or floaters in your field of vision
• Blurred vision
• Having a dark or empty spot in the center of your vision
• Difficulty seeing well at night

Complications: DR leads to abnormal growth of new vessels which will lead to visual complications such as:

• Vitreous Hemorrhage 
• Retinal Detachement 
• Glaucoma
• Blindness

How common is Diabetic Retinopathy? 

• After 5 years: 15-30%
• After 10 years: 35-50%
• After 15 years: 55-65%
• After 20 years: 65-85%
• After 30 years: 75-90%

Treatment: 

• Control of blood sugar
• Panretina Photocoagulation (PRP):

A course of photocoagulation usually involves one or more visits to a laser treatment clinic. An ophthalmologist will carry out the procedure, which is usually available on an outpatient basis. This means you will not have to stay in hospital overnight.

Before the procedure, you will be given a local anaesthetic to numb the surface of your eye and eye drops to widen your pupils. A special contact lens will be placed on your eye to hold your eyelids open and allow the laser beam to be focused onto your retina.

Small laser beams will be aimed at the damaged area of your retina. These will seal any blood vessels that are leaking and destroy any abnormal blood vessels that have grown in your retina.

Photocoagulation is not usually a painful procedure but you may feel a sharp pricking sensation when certain areas of your retina are being treated.

If you have had laser treatment in the past, you may experience some discomfort during the treatment. If this is the case, you may wish to ask your doctor for stronger painkilling medication or a mild sedative.

• Anti-VEGF intravitreal injection

Intravitreal anti-VEGF injections are given by an ophthalmologist on an outpatient basis. A few days before the procedure, you will be given antibiotic eye drops to help prevent infection.

Before the procedure, your eye and the skin around it will be cleaned and the area around your eye will be covered with a drape to keep it sterile (free of infection). A small clip will be used to keep your eye open during the procedure.

You will be given local anaesthetic eye drops to numb your eye so you do not feel any pain during the injection. Medication will be injected into your eye which stops the damaged blood vessels in your eye leaking.