Diabetic Retinal Problems
Long term elevated blood glucose levels can lead to changes in the microscopic blood vessels called capillaries in the retina. In the above section we outline the type of problems that we can encounter in the cerntral part of the retina called the macula. Here we outline some of the problems that can arise from slow, gradual, accumulating damage to these capillaries in the rest of the retina.
Loss of capillaries in the retina can lead on to a oxygen imbalance which causes the retina to release chemical signals that encourage the regrowth of blood vessels. This would sound to be a perfect solution to the initial problem of declining capillaries but sadly this is not the case. The abnormal blood vessels that can grow in the more advanced stages of diabetic eye disease are not healthy blood vessels and can serve no useful purpose for the eye. This stage of diabetic retinopathy is called PROLIFERATIVE DIABETIC RETINOPATHY .
Left untreated proliferative diabetic retinopathy can lead to severe eyesight loss in a fairly short space of time.
One of the major reasons for sight loss to occur as a result of proliferative diabetic retinopathy is the strong tendency for the abnormal blood vessels to break and bleed easily. A break in an area of ‘new blood vessels’ leads to release of blood into the vitreous cavity of the eye. Blood released here is termed ‘vitreous haemorrhage’ and can lead to very poor sight within a matter of seconds. Often the vitreous haemorrhage will over several weeks and month slowly clear away but such episodes can lead to a scarring response on the inner surface of the retina. If the process of proliferative diabetic retinopathy is left to run its course, a patient may develop repeated episodes of vitreous haemorrhage and the resultant inner retinal scarring can lead to a RETINAL DETACHMENT. This development can the lead to potentially irreversible sight loss occuring.
Its clear from the description of the untreated eye that patients who have been identified as having ‘new blood vessels’ on their screening tests require an urgent evaluation so that treatment can be considered on an urgent basis.
At Bettersight we have treated many hundreds of patients with diabetic retinopathy and our experience of the potential impact that Argon laser photocoagulation (PRP) of the retina can have in modifying the terrible course of proliferative diabetic retinopathy is generally a positive one.
We also consider it important for the general practitioner or diabetic physician to be actively involved in helping to optimise diabetic control once this level of eye disease is found. We feel improving diabetic control – wherever possible – will likely yield significant additional advantages for the longer term outcomes for patients with severe diabetic retinopathy.