Diabetic retinopathy (Eye damage: Eye and retina) is a serious complication of diabetes that affects 50% of patients with type 2 diabetes. The eyes are particularly sensitive to the involvement of small vessels. Diabetic retinopathy is the leading cause of blindness before age 65.
Causes and processes of diabetic retinopathy
At the end of the arteries are the capillaries, these small vessels that irrigate the parts of the body and the organs. Consisting of visual cells and traversed by a multitude of small vessels, the retina is the thin membrane of the eye that receives the light impressions from the outside. Via the optic nerve, it transmits them to the brain that translates them into images. The excess of sugar in the blood weakens the wall of the capillaries, causing a loss of tightness. It follows the rupture and the bursting of the retinal vessels.
Diabetic retinopathy and decreased visual acuity
As time goes by, large areas of the retina are no longer oxygenated. In response, the retina produces new, even more fragile vessels. The phenomenon is amplified and extends to the macula (area in the middle of the retina) where the center of vision is located. The macule thickens, there is macular edema (swelling of the macule), responsible for a decrease in visual acuity that can be very important and partially reversible.
In addition, the neovessels can bleed in a sheet in the vitreous in front of the retina, responsible for a loss of vision, until resorption of the hemorrhage. But this one may not be able to be resorbed and thus require a surgical removal (vasectomy). These phenomena can lead to the appearance of a fibrosis which can lead to traction of the retina with the risk of tearing and thus detachment of the retina, responsible for a permanent loss of vision.
Complications of diabetes in the eyes: no symptoms at first
While some eye disorders may indicate the presence of Diabetic Retinopathy (letters distorted reading, difficulty passing from light to darkness) the disease often occurs without giving warning signs. We can therefore have retinopathy even with good eyesight and in the absence of symptoms. Hence the importance of regular monitoring by a specialist and early detection. If the disease is allowed to spread, it will eventually affect the center of the eye and the retina, creating serious and irremediable visual disturbances.
In addition, retinopathy accelerates the occurrence of other eye diseases such as glaucoma or cataracts.
Prevention and treatment of diabetic retinopathy
If treatments exist and are effective (including laser) to curb the evolution of the disease and prevent blindness, the best treatment is prevention: by regular monitoring (at least once a year) in an ophthalmologist, the compromised blood pressure, controlled blood pressure and a healthy lifestyle.
The examinations of the ophthalmologist
The ophthalmologist conducts several examinations such as:
- The measurement of visual acuity
- The tension of the eye
- Even practice retinal angiography (which informs about the permeability of the retinal vessels)
- But the main control is the classic “fundus examination”, obtained by dilatation of the pupil
More recent and less restrictive, the non-mydriatic retinograph allows a digital photograph of the fundus without dilation of the pupil. Accurate, this examination, of a relatively short duration, can be realized by non-medical personnel (orthoptist or nurse). The more general use of this device would identify the many people who are not screened.
The French Federation of Diabetics defends the use and extension of this technique, which has the other advantage of being easily transportable. Pilot mobile screening experiments have already been conducted in this direction in the territory, with very positive results.