09 Nov 10 Facts About Diabetic Retinopathy
I will be speaking to a local patient group regarding the implications of diabetic retinopathy later this week. These are my “Top Ten” factoids about the eye disease.
Patients With Diabetes Need Annual Eye Exams
Without exception and at a minimum, both the AAO and AOA recommend that every patient with diabetes receive an annual eye exam. The pupils must be dilated to allow proper examination of the retina.
It doesn’t matter if you take insulin or not. The disease has no bias.
Diabetes Mellitus Affects the Retina
The retina is the light sensitive tissue that lines the inside of the eye. It is the principle tissue in the eye targeted by diabetes. Without a healthy retina, you can not see. It is perhaps the most important structure of the eye.
Diabetic Retinopathy May be Asymptomatic
Diabetic retinopathy is a slowly progressive disease. The key to saving vision is early diagnosis and before there are any symptoms of blurred or decreased vision. Don’t let good vision fool you into thinking there is nothing wrong with your eyes!
Good Sugar Control Does NOT Prevent the Disease
There is nothing to prevent the development of diabetic retinopathy. While sugar control may slow the development of the disease, there is no proof that it will actually prevent the disease. Most doctors and patients are unaware of this one fact.
Diabetic Retinopathy Can Cause Blindness
While diabetic retinopathy can cause a spectrum of vision loss, true blindness is quite rare. In fact, fewer than 1% of patients with diabetes will sustain “significant” vision loss in their lifetime.
In other words, blindness may be prevented most of the time, but early detection and treatment is essential.
Ophthalmologist or Optometrist Doesn’t Matter
In my opinion, not shared by many of my colleagues, I don’t think it matters if you are examined by an ophthalmologist (M.D.) or optometrist (O.D.). In my experience, most eye doctors are able to identify/recognize diabetic retinopathy. You should then be referred to a retinal specialist.
Diabetic retinopathy has a characteristic appearance that can be recognized easily.
Retinal Specialists Treat Retinal Disease
Okay, no kidding, but my point is that there are many ways to treat diabetic retinopathy. While you may not be examined regularly by a retina specialist, you should evaluated by a retinal specialist once the disease is diagnosed.
There are so many treatments available to you at this time to improve or stabilize your condition.
Every Patient With Diabetes Will Develop the Disease
I have seen very few patients with diabetes over 30 years that are lucky enough not to have developed the disease. I think it is safe to say that most will develop the disease and I tell all my patients to expect the diabetic retinopathy to develop.
Why? If you expect the disease to develop, you are most likely going to have regular exams. If you expect the disease to develop, then you get rid of the “denial” and seek proper medical treatment. Also, by expecting to develop the disease, you won’t feel disappointed in yourself for failing to take better care of your health.
Macular Edema and Proliferative Diabetic Retinopathy
There are only two “stages” that require treatment. Swelling in the macular area is called macular edema. Macular edema causes blurry vision. Most diabetic patients get this form.
Proliferative diabetic retinopathy (PDR) affects fewer patients, but can lead to blindness if not treated.
Both macular edema and PDR may occur simultaneously.
anti-VEGF, Laser, Steroids and Vitrectomy for Diabetic Retinopathy
We now have an array of treatments depending on the stage and severity. Regardless of the treatment, early detection gives you the best prognosis for maintaining your vision!
Maggie JacobyPosted at 13:00h, 09 November
Thanks so much for this great post, Randy. Thought you might be interested to know that Helen Keller International has recently begun diabetic retinopathy programs in both Bangladesh and Indonesia. Our goal is to specifically address the vision problems and blindness associated with this condition. In fact, we recently blogged about our efforts in Bangladesh: http://www.hki.org/blog/2010/11/diabetes-and-your-eyes-report-from-bangladesh/
Randall V. Wong, M.D.Posted at 13:14h, 09 November
Good luck with the effort and the blog. If I can be of any help, please reach out!
Stay in touch.
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Brad NitalPosted at 14:59h, 27 November
Thanks for posting this, it was an interesting read. I’m researching stem cell related diabetic retinopathy treatments, and came across this post. I also read the posts you made in October of 2009 related to stem cell treatments.
Are you familiar with the work of Dr. Shi-Jiang Lu? He’s done some interesting work on stem cell derived hemangioblast vasculature repair.
Two of his research papers, if interested:
Dr. Lu is also affiliated with Advanced Cell Technology – they are the company that the FDA just approved on Monday for a clinical trial for stem cell related treatment of Stargardt’s.
I realize it’s not your area of expertise, but I hope you revisit the topic of stem cell treatment options for diabetic retinopathy (and other retina related issues) in another post sometime soon. The thoughts of an actual practitioner are always a nice reality check against research data and PR.
Randall V. Wong, M.D.Posted at 13:52h, 28 November
What a refreshing post! I am not familiar with Dr. Lu, but I appreciate the links. It will be interesting to follow the progress with Stargardt’s.
Thanks for the encouragement. It is all welcomed!