How to Slow the Progression of Diabetic Retinopathy (pegged to National Diabetes Month)

November is National Diabetes Month, a time to educate yourself about diabetes as a whole — who gets it, what the symptoms are, and how you can manage the disease on a day-to-day basis.

There’s a lot to reflect on, because according to the Centers for Disease Control and Prevention (CDC), about 34.2 million Americans — 10.5% of the population — had been diagnosed with diabetes in 2018. And the numbers are likely to go much higher, as we live in a culture that values high-sugar and high-fat foods but doesn’t value physical exercise, leading to increasing levels of obesity.

Diabetes reflects the level of glucose (a sugar used by the cells for energy) in the bloodstream. Normally, when you eat, your pancreas produces the hormone insulin to shepherd the sugar from the blood into the cells. With diabetes, either your pancreas doesn’t produce enough insulin to process what you eat (Type 1), or the cells become resistant to the hormone’s effect (Type 2). In both cases, your blood sugar level rises too high, damaging tissue throughout the body.

At Retina Specialists, our team of expert ophthalmologists regularly performs diabetic eye exams at our five locations around the Dallas, Texas, area. We’re committed to diagnosing and treating diabetes complications affecting the eyes, including diabetic retinopathy, which can rob you of sight.

There are ways to slow the progression of retinopathy; our experts explain them here.

Looking at the eye

A good way to examine the structure of the eye is to start at the front where the light enters and follow its path from there. 

The surface of the eye is covered with a clear, curved membrane. The clearness allows the light to pass through. The curvature focuses the light that strikes it.

The focused light travels through a fluid-filled area called the anterior chamber (containing the aqueous humor), then through the hole of the pupil, and then through a clear lens that refines the focus. Finally, it passes through another chamber (containing the vitreous humor) and strikes the light-sensitive retina at the back.

The retinal tissue converts the focused light into electrical signals, which it sends to the brain through the optic nerve located behind it. Your brain decodes the signals, allowing you to “see.”

The central 2% of the retinal tissue is called the macula, and it’s what registers your clear, central vision. Blood vessels in and behind the retina nourish the tissue.

The problem of diabetic retinopathy

Regular eye exams are imperative for diabetics, because elevated sugar levels can interfere with your visual health, even leading to vision loss if not treated early enough. In fact, diabetic retinopathy is a leading cause of blindness, affecting one in three US adults over 40 with diabetes.

The early stage of the condition is called nonproliferative diabetic retinopathy. High sugar levels cause blood vessels to weaken, and they leak blood into the retina, which swells as a result. If the macula swells, it’s called macular edema.

This early stage generally leads to blurry vision. If it’s not treated, and if you don’t have the diabetes under control, it can progress to proliferative diabetic retinopathy.

This new stage is two-pronged. First, blood vessels begin to seal themselves off, preventing the delivery of oxygen and nutrients to your macula. Second, as a result of the starvation, new vessel growth proliferates on the retina’s surface. These are abnormal vessels and highly delicate. They often leak blood into the vitreous humor, compounding the problem.

Slowing the progression of diabetic retinopathy

At Retina Specialists, we have treatments that can slow the progression of diabetic retinopathy, no matter which stage you’re at. The specific treatment, though, depends on your eye health, the stage of disease, any other eye problems, and medical control of your blood sugar levels.

One treatment uses a drug that targets vascular endothelial growth factor (VEGF), a protein that creates new blood vessels when your body needs them; it was repurposed from a colon cancer drug that starved tumors of their blood supply. The team uses intraocular injections of anti-VEGF drugs to prevent new blood vessels from developing. That can reduce swelling, slow vision deterioration, and possibly even improve vision.

Another treatment is laser surgery to seal harmful blood vessels, thereby reducing swelling and preventing regrowth.

If your retinopathy is very advanced, you may need surgery like a vitrectomy. Your ophthalmologist removes the damaged vitreous humor, abnormal blood vessels, and scar tissue from your eye, allowing for normal retinal function.

If you’re a diabetic and it’s been a while since your last eye exam, it’s time to come into Retina Specialists for a diabetic eye exam to ensure all is well. Call us at any of our five Texas offices — in Dallas, DeSoto, Plano, Mesquite, and Waxahachie.