Diabetic retinopathy: what is it?
Diabetic retinopathy is one of the most common and serious complications of diabetes mellitus, and it is one of the leading causes of preventable vision loss in working-age adults worldwide. Because it is a silent condition, especially in its early stages, many patients are unaware of the damage taking place in their retina until the disease is advanced.
What diabetic retinopathy is
Diabetic retinopathy is a condition affecting the blood vessels of the retina — the light-sensitive layer of tissue at the back of the eye — caused by the high, sustained blood glucose levels characteristic of diabetes. Over time, these elevated levels progressively damage the tiny blood vessels that supply the retina, causing them to weaken, become blocked or, in more advanced stages, to form new, abnormal and fragile blood vessels.
According to the International Diabetes Federation (IDF), diabetic retinopathy affects a very significant proportion of people with diabetes over the course of their lives, particularly when glycaemic control has not been optimal for years.
Why is it a silent complication?
One of the most dangerous features of diabetic retinopathy is that, in its early stages, it usually causes no noticeable symptoms. Vision may remain apparently normal while the damage to the retinal vessels progresses silently. This explains why many patients only see an ophthalmologist once they already have obvious visual disturbances, by which point the disease may be at a more advanced stage that is harder to treat.
Symptoms that may appear in advanced stages
As the disease progresses, a number of symptoms may appear that are worth being aware of and that call for urgent ophthalmological assessment:
- Blurred or fluctuating vision.
- The appearance of dark spots or floaters in the field of vision.
- Difficulty perceiving colours normally.
- Progressive loss of visual acuity.
- In severe cases, sudden loss of vision.
Risk factors
The main risk factor for developing diabetic retinopathy is the length of time a person has had diabetes, combined with inadequate glycaemic control sustained over time. Other factors that increase the risk are poorly controlled high blood pressure, elevated cholesterol levels, pregnancy in women with pre-existing diabetes, and smoking. Controlling all of these factors together is essential to reduce the risk of the disease progressing.
The importance of regular check-ups
Early detection is the most effective tool for preventing the vision loss associated with diabetic retinopathy. For this reason, the leading scientific bodies, including the American Diabetes Association (ADA), recommend that everyone with diabetes has regular eye examinations, even in the absence of symptoms. How often these check-ups are needed should be tailored to each patient according to the type of diabetes, how long they have had it, and their degree of metabolic control.
In addition to ophthalmological follow-up, proper control of blood glucose, blood pressure and the lipid profile plays a decisive role in preventing this complication and slowing its progression.
How we can prevent diabetic retinopathy
Preventing diabetic retinopathy is based on a comprehensive approach to the disease: keeping blood glucose levels within the established targets, controlling blood pressure and cholesterol, avoiding tobacco, and attending the recommended medical and eye check-ups. Regular medical follow-up makes it possible to adjust treatment at an early stage and to significantly reduce the risk of serious eye complications.
As part of the specialist diabetes care provided by Dr Christian Leyva, the control and monitoring of chronic complications — including diabetic retinopathy — is a fundamental part of each patient’s care plan, in coordination with other specialists where necessary.
When diabetic retinopathy is diagnosed at an advanced stage, there are various ophthalmological treatment options, such as laser photocoagulation or intravitreal injections, which can halt the progression of the disease and, in many cases, preserve a significant part of the patient’s vision. However, these treatments are more effective and less invasive the sooner they are started, which once again underlines the importance of early detection through regular check-ups, even when there are no visual symptoms