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Facts About
Diabetic Retinopathy
| CONTENT LIST What is the retina? How does diabetic retinopathy damage
the retina? Who is at risk for this
disease? What are its symptoms? How is it detected? How is it treated? What research is being done? | Looking for more exclusive Biotech Information? |  | In addition to our free knowledge base, BiotechWatch provides the following additional services: - Premium Database, for in-depth coverage of biotechnology companies in the sector, giving the user the ability to search and sort based on more than twenty parameters.
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What can you do to protect your
vision? |
Information for Patients
This pamphlet has been written to help
people with diabetic retinopathy and their families
and friends better understand the disease. It
describes the cause, symptoms, diagnosis, and
treatment of diabetic retinopathy. Diabetic retinopathy is a potentially blinding
complication of diabetes that damages the eye's
retina. It affects half of all Americans diagnosed
with diabetes. At first, you may notice no changes in your
vision. But don't let diabetic retinopathy fool you.
It could get worse over the years and threaten your
good vision. With timely treatment, 90 percent of
those with advanced diabetic retinopathy can be saved
from going blind. The National Eye Institute (NEI) is the Federal
government's lead agency for vision research. The NEI
urges all people with diabetes to have an eye
examination through dilated pupils at least once a
year.
The retina is a light-sensitive tissue
at the back of the eye. When light enters the eye,
the retina changes the light into nerve signals. The
retina then sends these signals along the optic nerve
to the brain. Without a retina, the eye cannot
communicate with the brain, making vision
impossible. 
How does diabetic retinopathy damage
the retina?Diabetic retinopathy occurs when
diabetes damages the tiny blood vessels in the
retina. At this point, most people do not notice
any changes in their vision. | Looking for more exclusive Biotech Information? | | In addition to our free knowledge base, BiotechWatch provides the following additional services: - Premium Database, for in-depth coverage of biotechnology companies in the sector, giving the user the ability to search and sort based on more than twenty parameters.
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Some people develop a condition called
macular edema. It occurs when the damaged
blood vessels leak fluid and lipids onto the
macula, the part of the retina that lets us see
detail. The fluid makes the macula swell, blurring
vision. As the disease progresses, it enters its
advanced, or proliferative, stage. Fragile,
new blood vessels grow along the retina and in the
clear, gel-like vitreous that fills the inside of
the eye. Without timely treatment, these new blood
vessels can bleed, cloud vision, and destroy the
retina. | TOP |
All people with diabetes are at
risk--those with Type I diabetes (juvenile onset) and
those with Type II diabetes (adult onset). During pregnancy, diabetic retinopathy may also be
a problem for women with diabetes. It is recommended
that all pregnant women with diabetes have dilated
eye examinations each trimester to protect their
vision. | TOP |
Diabetic retinopathy often has no early
warning signs. At some point, though, you may have
macular edema. It blurs vision, making it hard to do
things like read and drive. In some cases, your
vision will get better or worse during the day. 
View of boys by person with normal vision.
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View of boys by person with diabetic retinopathy.
As new blood vessels form at the back of the eye,
they can bleed (hemorrhage) and blur vision. The
first time this happens it may not be very severe. In
most cases, it will leave just a few specks of blood,
or spots, floating in your vision. They often go away
after a few hours. These spots are often followed within a few days
or weeks by a much greater leakage of blood. The
blood will blur your vision. In extreme cases, a
person will only be able to tell light from dark in
that eye. It may take the blood anywhere from a few
days to months or even years to clear from the inside
of your eye. In some cases, the blood will not clear.
You should be aware that large hemorrhages tend to
happen more than once, often during sleep. | TOP |
Diabetic retinopathy is detected during
an eye examination that includes: Visual acuity test: This eye chart test
measures how well you see at various
distances.
Pupil dilation: The eye care professional
places drops into the eye to widen the pupil. This
allows him or her to see more of the retina and
look for signs of diabetic retinopathy. After the
examination, close-up vision may remain blurred for
several hours.
Ophthalmoscopy: This is an examination of
the retina in which the eye care professional: (1)
looks through a device with a special magnifying
lens that provides a narrow view of the retina, or
(2) wearing a headset with a bright light, looks
through a special magnifying glass and gains a wide
view of the retina.
Tonometry: A standard test that determines
the fluid pressure inside the eye. Elevated
pressure is a possible sign of glaucoma, another
common eye problem in people with diabetes. Your eye care professional will look at your
retina for early signs of the disease, such as: (1)
leaking blood vessels, (2) retinal swelling, such as
macular edema, (3) pale, fatty deposits on the
retina--signs of leaking blood vessels, (4) damaged
nerve tissue, and (5) any changes in the blood
vessels. Should your doctor suspect that you need treatment
for macular edema, he or she may ask you to have a
test called fluorescein angiography. | Looking for more exclusive Biotech Information? | | In addition to our free knowledge base, BiotechWatch provides the following additional services: - Premium Database, for in-depth coverage of biotechnology companies in the sector, giving the user the ability to search and sort based on more than twenty parameters.
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In this test, a special dye is injected into your
arm. Pictures are then taken as the dye passes
through the blood vessels in the retina. This test
allows your doctor to find the leaking blood
vessels. | TOP |
There are two treatments for diabetic
retinopathy. They are very effective in reducing
vision loss from this disease. In fact, even people
with advanced retinopathy have a 90 percent chance of
keeping their vision when they get treatment before
the retina is severely damaged. These two treatments are laser surgery and
vitrectomy. It is important to note that
although these treatments are very successful, they
do not cure diabetic retinopathy. Laser Surgery Laser surgery is performed in a doctor's office or
eye clinic. Before the surgery, your ophthalmologist
will: (1) dilate your pupil and (2) apply drops to
numb the eye. In some cases, the doctor also may numb
the area behind the eye to prevent any
discomfort. The lights in the office will be dim. As you sit
facing the laser machine, your doctor will hold a
special lens to your eye. During the procedure, you
may see flashes of light. These flashes may
eventually create a stinging sensation that makes you
feel a little uncomfortable. You may leave the office once the treatment is
done, but you will need someone to drive you home.
Because your pupils will remain dilated for a few
hours, you also should bring a pair of
sunglasses. | Looking for more exclusive Biotech Information? | | In addition to our free knowledge base, BiotechWatch provides the following additional services: - Premium Database, for in-depth coverage of biotechnology companies in the sector, giving the user the ability to search and sort based on more than twenty parameters.
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For the rest of the day, your vision will probably
be a little blurry. If your eye hurts a bit, your eye
care professional can suggest a way to control
this. 
The retina prior to focal laser treatment.
The retina immediately after focal laser
treatment.
Doctors will perform laser surgery to treat severe
macular edema and proliferative
retinopathy. Macular Edema: Timely laser surgery
can reduce vision loss from macular edema by half.
But you may need to have laser surgery more than once
to control the leaking fluid. During the surgery, your doctor will aim a
high-energy beam of light directly onto the damaged
blood vessels. This is called focal laser
treatment. This seals the vessels and stops them
from leaking. Generally, laser surgery is used to
stabilize vision, not necessarily to improve it. Proliferative Retinopathy: In
treating advanced diabetic retinopathy, doctors use
the laser to destroy the abnormal blood vessels that
form at the back of the eye. 
Scatter laser treatment.
| Looking for more exclusive Biotech Information? | | In addition to our free knowledge base, BiotechWatch provides the following additional services: - Premium Database, for in-depth coverage of biotechnology companies in the sector, giving the user the ability to search and sort based on more than twenty parameters.
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Rather than focus the light on a single spot, your
eye care professional will make hundreds of small
laser burns away from the center of the retina. This
is called scatter laser treatment. The
treatment shrinks the abnormal blood vessels. You
will lose some of your side vision after this surgery
to save the rest of your sight. Laser surgery may
also slightly reduce your color and night vision. Once you have proliferative retinopathy, you will
always be at risk for new bleeding. This means you
may need treatment more than once to protect your
sight. Vitrectomy Instead of laser surgery, you may need an eye
operation called a vitrectomy to restore your
sight. A vitrectomy is performed if you have a lot of
blood in the vitreous. It involves removing the
cloudy vitreous and replacing it with a salt
solution. Because the vitreous is mostly water, you
will notice no change between the salt solution and
the normal vitreous. Studies show that people who have a vitrectomy
soon after a large hemorrhage are more likely to
protect their vision than someone who waits to have
the operation. Early vitrectomy is especially effective in people
with insulin-dependent diabetes, who may be at
greater risk of blindness from a hemorrhage into the
eye. Vitrectomy is often done under local anesthesia.
This means that you will be awake during the
operation. The doctor makes a tiny incision in the
sclera, or white of the eye. Next, a small instrument
is placed into the eye. It removes the vitreous and
inserts the salt solution into the eye. You may be able to return home soon after the
vitrectomy. Or, you may be asked to stay in the
hospital overnight. Your eye will be red and
sensitive. After the operation, you will need to wear
an eyepatch for a few days or weeks to protect the
eye. You will also need to use medicated eye drops to
protect against infection. | Looking for more exclusive Biotech Information? | | In addition to our free knowledge base, BiotechWatch provides the following additional services: - Premium Database, for in-depth coverage of biotechnology companies in the sector, giving the user the ability to search and sort based on more than twenty parameters.
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| TOP |
The NEI is currently supporting a
number of research studies in both the laboratory and
with patients to learn more about the cause of
diabetic retinopathy. This research should provide
better ways to detect, treat, and prevent vision loss
in people with diabetes. For example, it is likely that in the coming years
researchers will develop drugs that turn off enzyme
activity that has been shown to cause diabetic
retinopathy. Some day, these drugs will help people
to control the disease and reduce the need for laser
surgery. | TOP |
The NEI urges all people with diabetes
to have an eye examination through dilated pupils at
least once a year. If you have more serious
retinopathy, you may need to have a dilated eye
examination more often. A recent study, the Diabetes Control and
Complications Trial (DCCT), showed that better
control of blood sugar levels slows the onset and
progression of retinopathy and lessens the need for
laser surgery for severe retinopathy. The study found that the group that tried to keep
their blood sugar levels as close to normal as
possible, had much less eye, kidney, and nerve
disease. This level of blood sugar control may not be
best for everyone, including some elderly patients,
children under 13, or people with heart disease. So
ask your doctor if this program is right for you. For more information about diabetic retinopathy or
diabetes, you may wish to contact: | Looking for more exclusive Biotech Information? | | In addition to our free knowledge base, BiotechWatch provides the following additional services: - Premium Database, for in-depth coverage of biotechnology companies in the sector, giving the user the ability to search and sort based on more than twenty parameters.
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American Academy of Ophthalmology
655 Beach Street
San Francisco, CA 94109-7424
(415) 561-8500
http://www.aao.org American Optometric Association
243 Lindbergh Boulevard
St. Louis, MO 63141
(314) 991-4100
http://www.aoanet.org American Diabetes Association
1701 N. Beauregard Street
Alexandria, VA 22311
(703) 549-1500
1-800-342-2383
http://www.diabetes.org Juvenile Diabetes Foundation
International
432 Park Avenue South
New York, NY 10016
(212) 889-7575
http://www.jdfcare.com National Diabetes Information
Clearinghouse
National Institute of Diabetes and Digestive and
Kidney Diseases
1 Information Way
Bethesda, MD 20892-3560
(301) 654-3327
http://www.niddk.nih.gov National Eye Institute
2020 Vision Place
Bethesda, MD 20892-3655
(301) 496-5248
http://www.nei.nih.gov Prevent Blindness America
500 East Remington Road
Schaumburg, IL 60173
1-800-331-2020
(847) 843-2020
http://www.preventblindness.org National Eye Institute
National Institutes of Health
NIH Publication No. 99-2171 | Looking for more exclusive Biotech Information? | | In addition to our free knowledge base, BiotechWatch provides the following additional services: - Premium Database, for in-depth coverage of biotechnology companies in the sector, giving the user the ability to search and sort based on more than twenty parameters.
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March 2000 |
