Understanding Diabetic Retinopathy

Understanding Diabetic Retinopathy

diabetic-retinopathy-2Diabetic retinopathy, a complication from diabetes mellitus, is currently the leading cause of blindness in the United States. The American Diabetes Association (ADA) estimated that in the years 2005 to 2008, 4.2 million Americans had some form of diabetic retinopathy. Diabetic retinopathy is damage to the small blood vessels of the retina of the eye, which can result in changes to vision and even blindness. If someone with diabetes has had very high blood glucose (sugar) levels for a long period of time, it causes damage throughout the body. These sugar molecules are very big, and the blood vessels in the eyes are very small and delicate. Over time, the constant presence of these large sugar molecules in the blood causes sugar to deposit in the small blood vessels of the eyes and damages them, resulting in vision changes and in severe cases blindness. Diabetic retinopathy does not develop over night, but instead takes many years to develop. Having diabetes for a long time, having both diabetes and high blood pressure, or having poorly controlled blood sugars all increase the risk of developing diabetic retinopathy. Diabetic retinopathy is one of the many reasons why it is very important for someone with diabetes to keep blood sugars under control.Controlling both blood sugars and blood pressure is the only way to slow the progression of diabetic retinopathy or reduce the risk of developing diabetic retinopathy.

The ADA currently recommends that individuals with Type 1 Diabetes get an eye exam by an ophthalmogist, not an optometrist, within five years of diagnosis. Individuals with type 2 diabetes should get an eye exam by an ophthalmogist shortly after diagnosis. It is important to get an eye exam close to the time of diagnosis so that an eye doctor can monitor any changes that may occur to the eyes over time. After the first eye exam, those with type 1 and type 2 diabetes should get an eye exam by an ophthalmogist every year. In addition to getting yearly eye exams, it is also important to recognize the signs and symptoms of diabetic retinopathy. Signs and symptoms may include blurred vision, floaters, changes in color vision, having a dark or empty spot in the center of vision, and vision loss. Anyone with diabetes who experiences any of the above symptoms should see an ophthalmogist immediately.

There are two stages of diabetic retinopathy, non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). NPDR is the earlier, less severe stage where the patient may not be experiencing any visual symptoms or may be starting to experience minor visual symptoms. Those with NPDR should be closely followed by an ophthalmogist to make sure the retinopathy does not get worse. The only way to treat NPDR is by controlling blood sugar and blood pressure to prevent diabetic retinopathy from worsening. PDR is the more advanced stage in which the small blood vessels of the eyes are very damaged from the high amount of sugar that has been in the blood over time. Because sugar in the blood has now damaged the eyes, it can result in severe visual symptoms. Some treatments for PDR include laser treatment, drug therapy, and surgical procedures. Treatment of PDR is very patient specific. If you are a patient with diabetes and have questions or concerns about diabetic retinopathy, talk to your healthcare provider today.

This article is brought to you by our guest writers:
Kayla Natali, PharmD candidate 2016
Jennifer Goldman, PharmD, CDE, BC-ADM, FCCP, Professor of Pharmacy Practice, School of Pharmacy-Boston, MCPHS University, Boston, MA, Clinical Pharmacist, Well Life Medical, Peabody, MA

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