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With review and feedback from CEENTA retina specialist Duncan Berry, MD (Concord, Salisbury, University)
Diabetes can have major impacts on vision. But did you know that laser and other treatments are available for some of these vision issues?
Diabetes is a group of metabolic diseases where the body’s pancreas does not produce enough insulin or does not properly respond to the insulin it produces, resulting in high blood sugar levels. This is a serious and chronic condition affecting more than 29 million Americans. Type 1 diabetes is when your body doesn’t produce insulin. Type 2 diabetes is when your body either doesn’t respond well to insulin or your body doesn’t make enough insulin.
Diabetes can cause vision-threatening eye issues like diabetic macular edema and proliferative diabetic retinopathy.
Diabetic macular edema is when swelling in the central part of the retina occurs. The retina is nourished by blood vessels that are injured as the result of longstanding diabetes and results in the production of vascular endotherlial growth factor, which causes the retinal vessels to leak. This causes the macula (the central part of the retina) to thicken or swell, which leads to decreased vision.
Proliferative diabetic retinopathy occurs when there is damage to the small blood vessels in the retina, resulting in poor circulation to the retina. Vision may be lost because some of the retina tissue may die as a result of this inadequate blood supply. Retina tissue cannot grow back once it is lost. Poor circulation associated with diabetes may lead to the production of vascular endothelial growth factor (VEGF), which can cause new abnormal blood vessels and scar tissue to grow on the surface of the retina. This stage of diabetic retinopathy is referred to as “proliferative” because at this stage of the disease, new, abnormal blood vessels and scar tissue begin to grow on the surface of the retina. The vessels bleed into the middle cavity of the eye, causing vision loss because light cannot reach the retina. Scar tissue formation can also pull on the retina, detaching it from the back of the eye, resulting in vision loss.
It is possible to have diabetic retinopathy for a long time without noticing symptoms until damage has occurred. Some patients may experience a partial or total loss of vision. Other symptoms include blurred or double vision, difficulty reading, the appearance of spots or floaters, shadow across the field of vision, eye pain or pressure, and difficulty with color perception.
In the past, diabetic macular edema was treated primarily with laser placed around the macula. However, this has been replaced by the injection of anti-VEGF medications into the eye that decrease leakage from damaged blood vessels, which block VEGF and can improve vision. Focal laser is still used in select cases of diabetic macular edema.
A type of laser called panretinal photocoagulation is used to treat proliferative diabetic retinopathy up until recently when investigators at CEENTA help to demonstrate that the use of anti-VEGF into the eye can treat proliferative diabetic retinopathy as well as laser. Panretinal laser is used cauterize sick retina that can produces vascular endothelial growth factor (VEGF). These injection and laser reatments can be performed either in the office or in a hospital setting.
Whether you need laser treatment or injections, the retina specialists at CEENTA can treat your eyes for diabetes-related eye issues. Don’t hesitate to see one of our physicians today.
This blog is for informational purposes only. For specific medical questions, please consult your doctor. Would you like an appointment with a CEENTA ophthalmologist? Call 704-295-3000. You can also schedule an appointment online or through myCEENTAchart.
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