Diabetic Retinopathy is positively correlated with the duration of diabetes. There are other things which along with diabetes make retinopathy worse:

·         High Blood Pressure

·         Pregnancy

·         Smoking

INVESTIGATIONS FOR DIABETIC RETINOPATHY:

If diabetic retinopathy is noted, colour photographs of the retina may be taken and FLUORESCEIN ANGIOGRAPHY performed. This involves dilating the pupils and injection of a fluorescent dye into a vein in the arm. Photographs of the retina are taken rapidly as the dye passes through the retinal blood vessels. This test helps in determining if laser photocoagulation treatment is necessary. If treatment is to be done, it helps in identifying what structures and areas need treatment with laser.

OPTICAL COHERENCE TOMOGRAPHY (OCT), which is newer non-invasive diagnostic modality provides a cross-sectional view of the retina and helps in quantifying the amount and type of swelling and guides the treatment.

TREATMENT OF DIABETIC RETINOPATHY:

PHOTOCOAGULATION involves the use of a LASER beam to seal leaking blood vessels and prevent growth of abnormal blood vessels. This procedure does not require hospitalization. In background retinopathy, if blood vessels are leaking fluid into the macula, laser treatment stops the leakage and may improve or stabilize vision. In proliferative retinopathy, laser treatment may involve one or more sessions depending on the type or severity of retinopathy. Laser treatment significantly reduces the chances of severe visual loss by destroying the abnormal blood vessels and preventing growth of more such vessels. Vision may improve or stabilize within several weeks to a year. It is important to remember that laser treatment is not a one-time procedure. Regular follow-up is extremely important. Your doctor will tell you when to return for a check-up. 
              

INTRAVITREAL INJECTIONS – Recently, along with laser treatment, certain medication when injected into the eye or just outside the eye has shown encouraging results. These include anti-VEGF agents such as Avastin, Lucentis and Macugen. They act by reducing macular edema i.e. the swelling in the retina as well as inhibiting growth of abnormal new vessels, or by reducing bleeding from new vessels which may be refractory to conventional laser treatment.

Another agent used is the steroid Triamcinolone Acetonide. This can be either injected into the eye (intravitreally) or into the side of the eye (Sub-Tenons). This agent works well for diabetic macular edema (swelling). However, increase in eye pressure and increased incidence of cataract, are potential side effects. These medicines should therefore be used cautiously and judiciously.

VITRECTOMY (VITREOUS SURGERY) – If the vitreous is too clouded with blood or there is traction retinal detachment, laser treatment will not work. In this situation, a surgical procedure called VITRECTOMY needs to be performed. In this operation, opaque vitreous gel is removed from within the eye by a special instrument that simultaneously sucks and cuts the vitreous. Membranes on the retina which are responsible for traction and recurrent bleeding are dissected. More complete photocoagulation can then be carried out. In case of retinal detachment due to traction in severe cases, gas or silicone oil tamponade is paced at the end of the procedure.

REMEMBER

·           Diabetes is a common cause of blindness

• In case you are a diabetic for more than 5 years, there is a fair chance that you might have developed diabetic retinopathy
• You might have developed Diabetic Retinopathy, in spite of having good vision
  
  ·         For the early detection and to begin the treatment, you should see your retina specialist at regular intervals
  
  ·         Diabetic retinopathy is largely treatable condition. Early detection and treatment saves eyes.
  
  ·         You should keep your blood sugar level, hypertension, increased blood lipids & cholesterol and (kidney) disease well under control.
• Quit smoking
• Regular exercise and balanced diet.