What is retinopathy?

Anyone who has diabetes may develop retinopathy, a condition where the diabetes weakens and damages the tiny blood vessels in a part of your eye called the retina.  The retina is the layer of tissue in the eye that receives light and sends signals to the brain that are turned into pictures of what you see.  The damage to these blood vessels may lead to vision loss over time.  The damage may cause:

• Leaking blood vessels
• Closed blood vessels
• Weak new blood vessels

Diabetics should get regular eye exams to monitor the health of their eyes.

What puts you at risk for retinopathy?

Factors that may increase your risk of retinopathy include:

• High blood sugar (glucose) levels
• High blood pressure
• Having diabetes for a long time
• Family history

What are the symptoms?

Retinopathy can lead to different types of vision loss. The type you get will depend on where in the retina the vessels are damaged and include:

• Peripheral (side) vision loss
• Decreased or lost central vision
• "Cotton wool" spots

What are the types?

•1.     Nonproliferative diabetic retinopathy - the tiny capillaries in your retina leak and/or close, which over time can lead to moderate or severe vision loss if not treated. The stages of this type are:

• § Early nonproliferative - you have leakage outside the fovea, the center of the macula, which is the part of the retina that creates sharp central vision.
• § Macular edema due to focal leakage - you get areas of swelling and fluid deposits in the fovea
• § Macular edema due to diffuse leakage - the leakage spreads throughout the macula and causes swelling

• 2. Proliferative diabetic retinopathy - typically seen after you've had diabetes a long time. Weak vessels grow on your retina and cause vision problems. The stages of this type are:
• § Pre-proliferative - capillaries close and you get cotton wool spots
• § Proliferative - weak blood vessels grow because others have closed
• § Severe bleeding - weak new blood vessels burst and bleed into the vitreous
• § Traction retinal detachment - new blood vessels and scar tissue grow from the retina onto the vitreous, the clear, gel-like substance in the back of your eye. This can eventually cause detachment of your retina

How is diabetic retinopathy detected?

Dr. Baer or Dr. Hartzell will do the following to determine if you have diabetic retinopathy and if so, what type of retinopathy you have.

• Record your history - find out how long you've had diabetes, what you do to monitor it, whether you have a family history of diabetes, and what medications you take
• Measure your vision
• Give you tests to detect diabetic retinopathy
• o Slit lamp examination - to provide a view of the inside of your eye
• o Ultrasound - painless way to use sound waves to look at the shape of the inside of your eye
• o Fluorescein angiography - a special photograph of your retina that helps classify your condition and record changes in the blood vessels of the retina

How is diabetic retinopathy treated?