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Diabetic Mellitus is the leading cause of vision loss in adults aged 20–74 years. Diabetes affects our eyes through its effect on blood vessel of the eyes. The walls of these blood vessels (the basement membranes) weaken causing them to leak blood and/or protein and fluid (macular edema). This process is easily visualized through a dilated eye exam and is called Diabetic Retinopathy (DR). When a significant amount of blood vessel leakage and damage has taken place, the body attempts to heal itself by producing new blood vessels, a process known as Proliferative diabetic retinopathy (PDR). Unfortunately, the new vessels are generally smaller, weaker, and prone to causing a significant amount of bleeding, retinal detachment and glaucoma. As such PDR is a serious and vision threatening complication that needs immediate attention and management.
It is estimated over 300 million people worldwide have Diabetes, with over a third showing signs of retinopathy. Numbers that are expected to rise further due to the increasing prevalence of Diabetes, aging of the population and increasing of life expectancy.
Although a third have Diabetes, the prevalence of Diabetic eye disease generally depends on the type of Diabetes Mellitus one has. Approximately 40% of people with Type 1 and 20% with Type 2 have documented retinopathy. Of that approximately 75% of people with Type 1 develop Diabetic Retinopathy and 25% of patients with Type 2. Proliferative diabetic retinopathy is less common with only 3% of Type 2 patients developing it and 33% of Type 1 patients.
5 to 10% of Diabetics develop PDR. But 60% of Type 1 Diabetics will show some signs of Proliferative disease after having Diabetes for 30 years or longer.
Often, there are no symptoms in the early stages of Diabetic Retinopathy. As a result, early detection is critical to better manage this condition. Vision loss generally may not become evident to most patients until the Diabetic Retinopathy is severe.
The management of Diabetic Eye Disease depends on where and what part of the eye is affected. Patients with Diabetic Retinopathy and Proliferative Diabetic retinopathy are managed with ocular intravitreal injections and/or retinal laser surgery.
The laser surgery is performed in our Surgery center. Focusing on the retina, the laser light helps seal off leaking blood vessels and shrinks abnormally newly grown vessels. However, laser surgery often cannot restore vision that has already been damaged. The main purpose of laser is not to improve vision but rather is an attempt to prevent progression of the disease. If enough bleeding has taken place and/or retinal traction has taken place due to Proliferative Diabetic Retinopathy, pars plana vitrectomy may be necessary.
As such, it is important for all Diabetics to have yearly dilated eye examination. Finding diabetic retinopathy early is the best way to prevent vision loss.
The Fraser Eye Care Center Doctors have either authored or reviewed and approved this content.
