It is a complication of diabetes mellitus and represents the most common cause of blindness in the working -age population. The small vessels in the retina are damaged resulting in occlusion and leakage, and eventually in the formation of new vessels, fibrovascular bands and tractional retinal detachment. The occurrence of diabetic retinopathy is associated with duration of diabetes, poor glycemic control, hypertension, nephropathy , pregnancy and smoking. About 80 % of diabetics have some form of retinopathy after 15 years.
At the begining , a diabetic patient could not have any symptom,even if his o her retina have already some degree of damage. However as it gets worst, blurring of vision, graduate loss of vision, floaters and pain could happened
How is diagnosed?
A retina exam with dilated pupil with drops is necessary. Even if there are not any symptoms, every diabetic patient should have it. Many times eye fundus photography, fluorescein angiography, in which an special dye is inyected in a vein to obtain contrasted images, ocular coherent tomography or an ultrasound of the eye are required to get a deeper exam an a better evaluation of the disease.
If there any treatment?
Many patients wolud need only a periodic exam, some others, would need laser surgery, in order to seal those small leaking vessels that causes macular edema, or when applied scattered in the retina , to produce involution of the new vessels. When this is performed in the proper time, there is an important reduction in the risk to have a severe loss of vission. Laser treatment is done at the office.
When there is bleeding to the vitreous cavity, or when the fibrous bands are causing retinal detachment, a surgery called vitrectomy is necessary. The surgeon cut and aspirate the blood, remove the membranes and bands, and apply laser. These maneuvers could help the retina to reapply, and to stabilize the neovascular process. Some times intravitreal inyections with medications called anti angiogenics could be considered. VItrectomy surgery is an ambulatory process but it is done in the OR.