Diabetic retinopathy

In developed countries, diabetic retinopathy is currently the most common cause of blindness in people of working age. It affects 80 to 100 % of patients with type 1 diabetes, which is characterised by insulin dependence, and more than 60 % of patients with type 2 diabetes lasting more than 20 years. The disease develops in three stages:
 

1. non-proliferative retinopathy
2. pre-proliferative retinopathy
3. proliferative retinopathy

What is diabetic retinopathy?

Diabetic retinopathy is a disease associated with diabetes. „Retinopathy is caused by an increased amount of sugar in the blood, which, through subsequent changes in the vessel walls and blood flow, blocks and damages the fine blood vessels of the retina“, explains MUDr. Ivo Ďurkovič, MPH.

In this disease, bleeding into the retina occurs, parts of the retina become ischaemic (poorly supplied with blood) and swollen, and small blood vessels become occluded. It is a very dangerous disease that often leads to blindness.

Causes of diabetic retinopathy

The most common causes include:

• diabetes – how long it has lasted, and insufficient or neglected treatment
• high blood pressure
• inflammations and injuries of the eye
• eye surgery
• smoking
• excessive alcohol consumption
• hormonal contraception

Diabetic retinopathy: symptoms

The first stages of the disease are not painful and cause the patient no subjective difficulties. Symptoms often appear only when they already directly threaten vision. The most common signs of diabetic retinopathy include:

• a sudden, severe deterioration of vision
• blurred vision
• reduced visual acuity
• swelling in the area of the macula
• impaired colour sensitivity
• floaters, spots or black dots in front of the eyes

How to get rid of diabetic retinopathy

The aim of treating diabetic retinopathy is to slow it down and stabilise it, and to improve the patient's overall vision. Because the disease can develop painlessly and without obvious symptoms, regular eye check-ups are important, especially for patients with diabetes. The basic prerequisite for successful treatment is good metabolic control of diabetes and stabilised blood pressure and blood lipid levels.

Diabetic retinopathy has several stages, and the treatment is indicated accordingly.

Laser coagulation of the retina

As the name suggests, this method of treating diabetic retinopathy uses a laser to destroy the newly formed, inferior blood vessels. This protects the eye from their possible rupture and subsequent bleeding into the retina.

Pars plana vitrectomy

This method is used in advanced stages of the disease. The essence of this surgical procedure is the removal of the vitreous and treatment of the retina from the inside of the eye.
If needed, inert gases in various concentrations or silicone oil are usually applied into the vitreous cavity at the end of the procedure.

Application of anti-VEGF agents

These are repeated intravitreal injections of effective anti-growth factors, which prevent the growth of new, imperfect, bleeding blood vessels, leading to normalisation of the retinal thickness in the macula.