MUMBAI, 14 JULY, 2022 (GPN) /By -Dr. Prerana Shah Panoli, Consulting Ophtholmologist & Vitreo Retinal Surgeon, Shree Ramkrishna Netralaya (SRN): Diabetes is one of the ongoing endemics in the world. It affects the eye and can present with cataract, glaucoma and diabetic retinopathy. Diabetic retinopathy is the damage to the light sensitive layer of the eye called retina.

Diabetic retinopathy is a disease of small vessels. Diabetes will cause sorbitol to flow in your blood. Sorbitol will cause increased oxidative stress. Continued oxidative damage can cause bleeding, low oxygen supply, swelling, and detachment of retina. Treatment facilities of this is available at Shree Ramkrishna Netralaya, Thane, Mumbai and Navi Mumbai.  

Dr. Prerana Shah Panoli, Consulting Ophtholmologist & Vitreo Retinal Surgeon at Shree Ramkrishna Netralaya (SRN) elaborated the Diabetic retinopathy. The two are the presentations of diabetic retinopathy are called non-proliferative diabetic retinopathy or NPDR and proliferative diabetic retinopathy or PDR. NPDR is divided into mild, moderate and severe depending on what your doctor can see in the retina. The dilated small vessels called micro aneurysms will leak and cause fluid accumulation in the different layers of your retina. Long term fluid accumulation will cause lipid deposits in the layers of retina which is one of the common reasons of vision loss.

If oxidative stress continues, the larger blood vessels of your eye become dilated and frizzy and start leaking out blood .This causes red bleeding spots called hemorrhages to happen in your retina. Sometimes retinal neuronal swelling can cause white spots called cotton wool spots. The leakage can happen in the center of your eye called the macula. The macula is responsible for central sharp vision. Continued fluid leakage and accumulation of lipid deposits causes a drop in vision. It is called as diabetic macular edema. If it is significant to be diagnosed by a doctor it is called as clinically significant macular edema 

Dr. Prerana Shah Panoli said, If diabetes is not under control, the retina is under continued oxidative stress, oxygen or nourishment to all parts is reduced, new vessels or neovascularization will grow on the surface of retina. It is called as proliferative diabetic retinopathy (PDR) and needs immediate attention.

If the new vessels keep on leaking and bleeding they cause a fibrous or a scar tissue to form on the surface of retina. The bleeding into the jelly of the eye is called as vitreous hemorrhage .The fibrous and scar tissue is unhealthy and it causes the retina to contract and separate from its base. This is known as tractional retinal detachment which requires surgery.

In non-proliferative diabetic retinopathy (mild, moderate or severe) without any diabetic macular edema, the treatment remains good sugar control, good sugar control, good sugar control .If you have diabetic macular edema, we need to do a test called OCT or Optical Coherence Tomography which gives you an idea of how much edema or how much fluid in the retinal layers needs to be treated. The treatment options are laser photocoagulation or intravitreal injections (injection given inside the jelly of your eye called vitreous). Prior to laser photocoagulation, we may need to do fundus fluorescein angiography (FFA) which is study of blood vessels of the retina of the eye. Anti-vascular endothelial growth factor (Anti VEGF) injections help to decrease the diabetic macular edema.

Proliferative diabetic retinopathy is a disease of neovascularization treated with pan retinal photocoagulation (PRP) helps in regression of new vessels .It will prevent bleeding into the eye .In cases of tractional retinal detachment, we perform micro vitreoretinal surgery to remove the diseased jelly of the eye and flatten the retina. The outcomes of timely done surgery are good.

That is actually an excellent question. The first baseline checkup happens at diagnosis and includes vision testing, measurement of intraocular eye examination, retinal examination and if necessary an OCT or FFA. A flicker ERG can be used for screening early damage due to diabetic retinopathy, if necessary. The review is scheduled according to the diagnosis by the doctor.

Regular checkup is important .If you are a diabetic and you are experiencing vision problem, a timely checkup and necessary intervention can help you prevent vision loss.

If you are diagnosed with PDR, getting a pan-retinal photocoagulation on time can do wonders. Getting a recommended surgery for vitreous hemorrhage or tractional retinal detachment can prevent further damage and control vision loss.-Ends.