diabetic retinopathy

Some of the questions and answers people often ask about eye problems especially regarding eye problems after surgery. This page deals with eye problems related to diabetes and diabetic retinopathy.

What is diabetic retinopathy?

Diabetic retinopathy is a disease of the retina resulting from diabetes.

Who gets diabetic retinopathy?

Diabetic retinopathy is suffered by patients with diabetes who have had the condition for at least 6 and probably 10 or more years. Some patients have diabetes without knowing it and may have signs of diabetic retinopathy at the time that their diabetes is first diagnosed. Some patients who have surgery to clear a haemorrhage from the eye have some residual blood in the eye the next day, and may be aware that their vision is little better than pre-operatively. Other patients have quite severe retinal disease prior to the operation and as a result of which, regardless of the presence of gas or oil in the eye, vision will be poor and take some time to recover.

Will diabetic retinopathy affect my sight?

Most diabetics will develop some retinopathy within their lifetime. Most diabetics do not, however, lose any vision as a result of having diabetic retinopathy.

How could my sight be affected by diabetic retinopathy?

There are two important ways in which sight can be affected by diabetic retinopathy. The first is damage to the macula which is the part of the retina with which you read and recognise faces.

This is termed ‘Diabetic Maculopathy’. The second is as a complication of the growth or ‘proliferation’ of new blood vessels. Such ‘Proliferative Diabetic Retinopathy’ results in bleeding or haemorrhage into the vitreous jelly within the eye; it can also result in pulling on the retina and a specific type of retinal detachment.

What is the macula and how could my sight be affected by diabetic maculopathy?

The macula is the part of the retina which provides the finest quality vision. It is the central part of the vision and to many people the most important part of the vision.
It provides the finest quality vision and is the part of the eye with which you read and recognise faces. There are two different processes that may occur within the diabetic macula that results in loss of vision. The first is ischaemia (loss of blood supply) and the second is leaking from blood vessels with consequent waterlogging (or oedema, edema).

How does Ischaemic Maculopathy affect sight?

Ischaemic maculopathy occurs when there is loss of the very small blood vessels in the macula with a consequent impairment in retinal function.

Is there a treatment for Ischaemic Maculopathy?

Unfortunately at present we do not have effective treatment for ischaemic maculopathy. The most important factor here is prevention with good diabetic control and control of blood pressure

What does diabetic macular leakage cause and how does it affect sight?

Leakage manifests itself in two ways.

( 1 ) The first is that there may be waterlogging of the macula in either a localised or generalised fashion.
This waterlogging thickens the macula which disrupts its normal anatomy. It also means that the biological soup in which the electrical activity of the macula normally occurs is disrupted and abnormal. Both of these problems result in impaired function.

Pic : A cross sectional scan through a normal macula with a central depression.

Pic : A scan showing a waterlogged macula due to diabetic macular odema, the retina is thickened and the spaces result from disruption of the normal structure. ( 2 ) The second feature of leakage is deposition of exudates or fatty deposits. They tend to occur at the edge of areas of leakage. The exudate disrupts the structure of the retina and results in impaired function.

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