What is Diabetic Retinopathy? What are the symptoms?

Diabetic retinopathy is a disorder that occurs as a complication of diabetes and significantly affects vision. Diabetes, popularly known as diabetes, is a metabolic chronic disease characterized by abnormally high blood glucose levels. Diabetes is not only a disease that affects sugar levels, but also causes many complications by affecting the vascular and nervous systems. Retinopathy is one of the most common complications caused by diabetes. Diabetic retinopathy is a disorder that significantly affects vision, characterized by the vessels in the retina leaking blood or contents, the leaked fluid causing edema, the deformed vessels expanding and forming bubbles, and the formation of new capillaries or membranes. As the capillaries are deformed and ruptured, blood leaking behind the retina and deformed vascular tissue cause damage to the retina over time. As the retina gets damaged, vision decreases over time.

What is Diabetic Retinopathy?

Diabetic retinopathy is a disease that causes insidious progressive vision disorders that occur as a complication of high blood sugar levels. The retina is the part of the eye that contains many nerve fibers and vascular networks. In diabetic retinopathy, dilation and blood flow changes occur in the retinal vessels. Diabetic retinopathy stagesThere are two types: non-proliferative and proliferative. In the non-proliferative phase, abnormal expansion or narrowing of the retinal vessels, bleeding, and blood flow changes occur. In the proliferative phase, new vessel formations occur. These veins are dysfunctional and weak. At this stage when new vessels are formed, the retina may separate from the eyeball.

What Causes Diabetic Retinopathy?

There are many risk factors that lead to the development of diabetic retinopathy. Among these factors, the time of onset and severity of diabetes are the most decisive. “What causes diabetic retinopathy?” The risk factors that will answer the question are as follows:

• High blood pressure
• Pregnancy
• High uncontrolled blood sugar
• High cholesterol level
• Nephropathy
• Anemia
• High triglyceride level
• High body mass index
• History of cataracts
• Adolescence
• Having a sedentary lifestyle
• Having cardiovascular disease

Individuals with more than one risk factor monitor their blood sugar levels at regular intervals. They should have their measurements taken and undergo an eye examination.

What are the Symptoms of Diabetic Retinopathy?

Diabetic retinopathy symptoms vary depending on the size of the lesion and the severity of retinal damage. Diabetic retinopathy progresses insidiously, without symptoms at first. The disease is usually noticed after reaching a certain stage. Sometimes, no symptoms are observed for years, while sometimes blurred vision begins when the macular degeneration is affected. In cases where the parts of the visual center are not damaged and only the peripheral retina is damaged, the disease is detected quite late, as there is no loss of vision in the short term. In this case, while the vision does not become blurred, the person may suddenly lose his vision completely due to sudden bleeding that may occur in the capillaries. In addition, pain is not observed in people with only diabetic retinopathy and no other diseases.

One of the typical findings of diabetic retinopathy is the appearance of floaters in the eye. Patients usually feel the need to consult a doctor after this complaint. People who do not have regular eye examinations face the problem of suddenly decreasing vision, even though they have never had any vision problems before. This is an indication that the existing diabetic retinopathy is now advanced enough to cause symptoms. Diabetic retinopathy should not be considered a local organ disease. Because the vascular vessels in the retina are a part of the body's general cardiovascular system. Therefore, the progression of the disease makes treatment very difficult. People with diabetes should not skip their eye examinations in order to prevent all these problems.

How is Diabetic Retinopathy Diagnosed?

Since diabetic retinopathy is an insidious and progressive disease that does not initially cause symptoms, early diagnosis is very important. People with a history of diabetes should have regular eye examinations. The disease can be easily detected thanks to detailed eye examination and auxiliary diagnostic methods. Eye examinations are painless, quick and simple procedures. Ophthalmic additional methods to aid diagnosis are as follows:

• Ophthalmoscopy
• Fundus Fluorescein Angiography ( FFA)
• Optical Coherence Tomography (OCT)
• Retinal Thickness Analyzer (RTA)
• Fundus Photography

What are the Treatment Methods for Diabetic Retinopathy?

There are treatment methods for diabetic retinopathy such as lifestyle changes, medication and surgical intervention. Depending on the severity of the disease and the time of onset, it is decided which of these treatment methods will be applied. Treatment methods used in diabetic retinopathy are as follows:

• Retinal Laser (Photocoagulation): In photocoagulation, abnormal vascular formations or leaky vessels are burned by using light waves. Although laser treatment has the ability to slow down or even stop the progression of the disease, it does not provide any benefit in regaining lost vision.
• Medication Treatment: Steroids and anti-VEGF agents are preferred as drugs in diabetic retinopathy. Steroids are especially beneficial in eliminating edema in the retina. Anti-VEGF, which is a vascular endothelial growth factor, acts by binding to receptors in the narrowing or widening retinal capillaries.
• Vitrectomy: The eyeball is filled with a viscous fluid called vitreous. In the later stages of diabetic retinopathy, the vitreous loses its viscosity and separates from the eye wall. In this case, vitrectomy surgical intervention called diabetic retinopathy is used. Vitrectomy surgery performed by experts in the field has very low risks.

What is Diabetic Retinopathy Surgery?

In advanced and complicated diabetic retinopathy, conditions such as bleeding, retinal tears may occur, leading to advanced vision loss and even blindness. In this case, drug treatments are insufficient and surgery is needed. With "diabetic retinopathy surgery" called vitrectomy, bleeding in the eyeball is cleaned, abnormal new vascular formations or normally existing ruptured vessels are burned, and retinal tears are repaired.

In diabetic retinopathy surgery, the procedure is made by creating millimeter-sized incisions. is performed and there is usually no need for stitching afterwards. Hospitalization is usually not required before and after the surgery. If surgery is required for both eyes, different surgery dates are given for each eye. Contrary to popular belief, diabetic retinopathy surgery carries very little risk and should be performed under local anesthesia.

What Should Be Done to Prevent Diabetic Retinopathy?

There are many measures that can be taken to protect against diabetic retinopathy, from changing living conditions to quitting harmful habits. Diabetic retinopathy can be prevented by paying attention to the following conditions, especially nutrition:

• Regular. to have blood sugar measurements,
• If high blood sugar is present, to keep blood sugar under control by using necessary medications,
• To reduce the use of harmful addictive products such as alcohol and tobacco products, and to end it if possible,
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• Having regular blood pressure measurements and keeping blood pressure under control,
• Developing a healthy diet, including foods containing vitamins and minerals that will support the eyes,
• Away from a passive lifestyle. stopping and exercising,
• Having eye examinations at regular intervals,
• Determining whether there are other eye conditions that may trigger diabetic retinopathy and having them treated first.