Symptoms
The early stages of diabetic retinopathy typically have no symptoms. Some people notice changes in their vision while reading or looking at distant objects.
In later stages of the disease, blood vessels in the retina may start to bleed into the vitreous (the jelly-like fluid that fills the eye). If this occurs, patients may see dark, floating spots or streaks that resemble cobwebs. Sometimes these spots disappear on their own, but it is crucial to consult an ophthalmologist immediately. Without proper diagnosis and treatment, scarring can form at the back of the eye.
Symptoms may progress slowly – over months or years – with the presence of swelling and hemorrhages in the retina. They can also appear acutely, such as with a vitreous haemorrhage or retinal detachment.
As the disease progresses, the following main symptoms may appear:
- Blurred central vision
- Difficulty reading or focusing on details
- Floating spots or “floaters” in the visual field
- Straight lines appearing distorted
- Reduced color contrast
- A dark spot in front of the eye
- A moving or stationary “curtain” in front of the eye – due to haemorrhage or retinal detachment
Risk Factors
- Diabetic retinopathy is mainly caused by diabetes (Type 1, Type 2, or gestational diabetes).
- The condition arises due to damage to the small blood vessels in the retina as a result of persistently high blood sugar levels.
- People with other conditions such as high blood pressure and high cholesterol are at greater risk.
- Family history
* If you do not have diabetes but experience symptoms similar to diabetic retinopathy, this could be due to other eye conditions, such as:
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- Hypertensive retinopathy – caused by high blood pressure
- Ocular vascular disease – problems with circulation in the retina
- Inflammatory retinal diseases
- Age-related macular degeneration
Important: If you experience blurred vision, dark spots, or other vision problems, it is advisable to visit an ophthalmologist, even if you do not have diabetes!
Diagnosis
For diagnosing the condition, an examination includes viewing the fundus (back of the eye) with dilated pupils to check the retinal blood vessels for hemorrhages, aneurysms (areas of vessel swelling), and macular edema (swelling of the macula).
A non-invasive OCT-angiography (eye scan) can be requested. At VISION, we use the most modern SOLIX scanner, which instantly creates 3D images of the retinal layers and its vascular system. This allows the specialist to make an immediate diagnosis and prescribe the most suitable treatment.
Your ophthalmologist may also request a fluorescein angiography – an invasive examination where a contrast dye is intravenously injected, and a series of images are taken with a fundus camera to document the blood flow through the damaged retinal vessels.
Treatment
Treatment of diabetic retinopathy varies depending on the severity of the disease.
Injection therapy:
Medications may need to be injected into the eye to reduce inflammation or stop the formation of new blood vessels.
Laser therapy:
In more advanced stages of diabetic retinopathy, laser treatment may be required to stop bleeding or prevent new damage to the blood vessels. Laser therapy can also be combined with intravitreal medications in advanced stages.
VISION uses the most advanced French micropulse, multi-spot laser – the so-called “yellow” EasyRet laser, which is much gentler on the tissues and works significantly faster than conventional lasers.
Reduction of retinal swelling and the therapeutic effect develop gradually – typically between 6 and 8 weeks after treatment.
Surgical treatment:
In the most severe cases or advanced stages of diabetic retinopathy, when there are hemorrhages or significant retinal damage, surgical intervention (vitrectomy) may be necessary.
Care
The most important aspect is regular follow-up and maintaining control over diabetes and its associated risk factors.
- Regular Ophthalmologist Visits: People with diabetes should visit an ophthalmologist at least once a year for eye examinations to detect changes in the retina that may indicate diabetic retinopathy.
- Blood Sugar Control: One of the main factors for preventing diabetic retinopathy and slowing its progression is strict management of blood sugar levels. Consistently maintaining normal levels can reduce the risk of retinal damage.
- Blood Pressure Control: High blood pressure can worsen the condition of the retina, so it is important to control blood pressure through a healthy lifestyle and, if necessary, medication.
- Maintaining Healthy Cholesterol Levels: Lack of cholesterol control can also worsen the condition of the blood vessels in the retina. It is important to monitor cholesterol and take measures to regulate it if needed.
