Diabetic Retinopathy

The retina is a light-sensitive tissue at the back of the eye. When light is received by the eye, the retina translates the light into nerve signals. The retina then sends these signals along the optic nerve to the brain. Any damage to the Retina will alter the process of vision significantly and will ultimately lead to blindness if not treated.

• Diabetic retinopathy definition
  
  Diabetic retinopathy is a complication to diabetes and a leading cause of blindness. It occurs when constant elevation of blood sugar leads to damage of the tiny blood vessels inside the retina, the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision. Diabetic retinopathy usually affects both eyes.
   
• Symptoms of diabetic retinopathy
  
  There are usually no symptoms of background retinopathy, although gradual blurring of vision may occur if macular edema is present. You may never notice changes in your vision, and serious retinopathy can be present without any symptoms, until it is very serious. Ophthalmologists recommend that all patients with diabetes undergo regular eye examinations.
   
• Stages of diabetic retinopathy
  
  Diabetic retinopathy has four stages:
  1. Mild Nonproliferative Retinopathy: at this early stage, microaneurysms occur. They are small areas of balloon-like swellings in the retina's tiny blood vessels.
  2. Moderate Nonproliferative Retinopathy: as the disease progresses, some blood vessels that nourish the retina are blocked.
  3. Severe Nonproliferative Retinopathy : many more blood vessels are blocked, depriving several areas of the retina of their blood supply. These areas of the retina send signals to the body to grow new blood vessels for nourishment.
  4. Proliferative Retinopathy: at this advanced stage, the signals sent by the retina for nourishment trigger the growth of new blood vessels. This condition is called proliferative retinopathy. These new blood vessels are abnormal and fragile. They grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye.

  (See diagram above)

By themselves, these blood vessels do not cause symptoms or vision loss. However, they have thin, fragile walls. If they leak blood, severe vision loss and even blindness can result.

• Macular edema treatment
  
  Macular edema is treated by thermal laser procedures, some new techniques of intra ocular injection of a corticosteroid is now available.
   
• Diabetic retinopathy treatment
  
  During the first three stages of diabetic retinopathy, no treatment is needed, unless you have macular edema. To prevent progression of diabetic
  retinopathy, people with diabetes should control their levels of blood sugar, blood pressure, and blood cholesterol.
  Proliferative retinopathy is treated by laser procedure. This procedure is called scatter laser treatment. Scatter laser treatment helps to shrink the abnormal blood vessels.
  Scatter laser treatment works better before the fragile, new blood vessels have started to bleed. That is why it is important to have regular, comprehensive dilated eye exams. Even if bleeding has started, scatter laser treatment may still be possible, depending on the amount of bleeding.
  If bleeding is severe, you may need a surgical procedure called a vitrectomy. During a vitrectomy, blood is removed from the center of the eye.
  

Scatter laser treatment

• The role of Ocuguard in diabetic retinopathy:
   
  1. (Anti-oxidant vitamins ) Free radicals form in diabetes mellitus and increase by time which play a role in the development of diabetic retinopathy, which is an important complication of the disease.
  2. During the first stages of diabetic retinopathy, there is an ischemia due to lack of oxygen, so ginkgo biloba may play a role as it;
     • Improves microcirculation.
     • Increases RBCs flexibility.
     • Decreases RBCs & platelet hyperaggregation.
     • Is a powerful antioxidant