Diabetic Retinopathy

Chronically high blood sugar from diabetes is associated with damage to the tiny blood vessels in the retina, leading to diabetic retinopathy. The retina detects light and converts it to signals sent through the optic nerve to the brain. Diabetic retinopathy can cause blood vessels in the retina to leak fluid or hemorrhage (bleed), distorting vision. In its most advanced stage, new abnormal blood vessels proliferate (increase in number) on the surface of the retina, which can lead to scarring and cell loss in the retina.


Diabetic Retinopathy risk factors include:

SIGNS AND SYMPTOMS OF DIABETIC RETINOPATHY MAY INCLUDE:

DIABETIC RETINOPATHY IS CLASSIFIED INTO:

Background retinopathy:  Is an early stage of retinal damage when small blood vessels in the retina show signs of damage that can result from diabetes.  As retinal arteries does not receive proper oxygen, ischemia develops because of which there will be outpouching of arteries.

Mild nonproliferative retinopathy. Small areas of balloon-like swelling in the retina’s tiny blood vessels, called microaneurysms, occur at this earliest stage of the disease. These microaneurysms may leak fluid into the retina. TREATMENT IS GIVEN TO PREVENT THE FURTHER CHANGES IN RETINA AND TO AVOID PROGRESSION OF DISEASE FROM MILD NPDR TO MODERATE NPDR BY IMPROVING THE RETINAL STATUS.

MODERATE NPDR:  More than just microaneurysms but less severe NPDR.

Moderate nonproliferative retinopathy. As the disease progresses, blood vessels that nourish the retina may swell and distort. They may also lose their ability to transport blood. Both conditions cause characteristic changes to the appearance of the retina and may contribute to DME.

SEVERE NPDR

Many more blood vessels are blocked, depriving blood supply to areas of the retina. These areas secrete growth factors that signal the retina to grow new blood vessels.

Any of the following (4-2-1 rule) and no signs of proliferative retinopathy:

International Classification

Any of the following and no signs of PDR

PROLIFERATIVE DIABETIC RETINOPATHY

Proliferative diabetic retinopathy (PDR) is the more advanced form of the disease. At this stage, circulation problems deprive the retina of oxygen. As a result new, fragile blood vessels can begin to grow in the retina and into the vitreous, the gel-like fluid that fills the back of the eye. The new blood vessels may leak blood into the vitreous, clouding vision.

Characterized by growth of new vessels on the surface of the retina.

Signs:

Fine to severe loops of new vessels that may grow on the optic disc: neovascularization of the disc (NVD) or elsewhere (NVE)

In the anterior segment, PDR is manifested by neovascularization of the iris (NVI), the angle (NVA) and may eventually complicated with neovascular glaucoma

These new vessels may leak and resulting in retinal edema. They are also fragile and prone to bleed

Opaque fibrovascular proliferation tissue often appears on the internal limiting membrane (adjacent to the new vessels) and becomes adherent to the vitreous

Contraction of this fibrovascular tissue may lead to:

Risk factors:

One or both of the following:

PDR WITH TRACTIONAL RETINAL DETACHMENT(TRD)

IN THIS CONDITION OF RETINA OUR TREATMENT HELPS IN  STABILITY OF RETINA DEPENDING ON THE TRACTIONS AND WHEN THERE IS NO RETINAL DETACHMENT