Diabetic retinopathy: detecting it early is key

Written by: Dr. Roberto Gallego Pinazo
Edited by: Top Doctors®

The eye is a target organ of the chronic disease that diabetes induces in the blood vessels. It is characterized by an involvement of both the retinal vessels and the macula, producing respectively diabetic retinopathy and diabetic macular edema.

Symptoms of diabetic retinopathy

In the early stages, when the first signs appear in the fundus of the eye with involvement of the retina by diabetes, there are no symptoms. They are signs that do not produce visual alterations or defects in the visual function and this is what makes it imperative to carry out a series of periodic checks of the fundus of the eye so that a specialist can make the diagnosis at the earliest and avoid that alterations develop Which lead to a severe and irreversible loss of vision.

In the absence of treatment, when diabetic retinopathy progresses uncontrollably, symptoms range from flying flies through intraocular hemorrhages to spots in the central and pericentral vision field due to macular edema and even total loss of vision when they occur Severe alterations in the circulation or anatomy of the retina.

Risk Factors for Diabetic Retinopathy

Diabetes is the essential risk factor, in addition to its evolution time and the metabolic control that the patient gets. The longer the progression and the poorer metabolic control (blood glucose, cholesterol, triglycerides, blood pressure, etc.) progressively increase the chances of developing eye disease due to diabetes.

Diagnosis of diabetic retinopathy

One of the main socio-health objectives in comprehensive diabetes patient care is to ensure a diabetic retinopathy screening process in order to be able to make a diagnosis early enough to avoid severe loss of vision.

To accomplish this, the international follow-up protocols must be fulfilled by photographs of the retina, spaced over time throughout the patient's life according to the signs observed during the sequence. Signs include haemorrhages in the retina, small vascular abnormalities called microaneurysms, exudates of both lipid (hard exudates) and cottony (soft exudates), and more severe alterations of blood vessels such as venous arrosaramiento, microvascular intraretinal or neovasal abnormalities.

Through optical coherence tomography, the anatomical structure of the macula can be analyzed and it can detect minimal changes.

Treatment for diabetic retinopathy

Treatment depends on degree of involvement. Options include retinal laser treatment, intraocular drug injections, or intraocular surgery through vitrectomy. Currently, with adequate treatment, the vast majority of cases of ocular involvement due to diabetes can be controlled to avoid severe loss of vision.

In the first photograph we can see a patient with type 1 diabetes with stable diabetic retinopathy and vision of 100%.



The second picture refers to the same patient at age 2, due to poor control of diabetes and in the absence of follow-up during that interval there is a severe progression of ocular involvement with severe loss of vision.



The third photograph shows a structural optical coherence tomography that shows severe diabetic macular edema with significant visual impairment.


*Translated with Google translator. We apologize for any imperfection

By Dr. Roberto Gallego Pinazo

Dr. Gallego Pinazo is a first level specialist in Ophthalmology , graduated in Medicine and Surgery from the University of Valencia , Cum Laude Doctorate from the same university and Diploma in Higher Studies in Ophthalmology from the European School of Advanced Studies in Ophthalmology of Lugano (Switzerland). In 2012 he did a fellowship under the tutelage of Dr. Lawrence A. Yannuzzi and Dr. K. Bailey Freund in various American centers: Vitreos Retina Macula Consultants in New York, the Royal Manhattan Eye Hospital, Ear and Throat and the New York University Bellevue Hospital.

He was a consultant in the Macula Unit of the Ophthalmology service of the Valencia University Hospital and Polytechnic of Valencia between 2008 and 2017. He is also a principal investigator in several centers and entities, as well as the author of more than 180 publications in international journals. He is also co-editor of the Spanish Journal of Macular Pathology and Co-Founder of the Spanish Club of the Macula . He is a member of the editorial committee, serving as associate editor responsible for the retina section of the journals of the Spanish Society of Ophthalmology and BMC Ophthalmology.

*Translated with Google translator. We apologize for any imperfection

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