What is the difference between NPDR and macular edema?
NPDR (non-proliferative diabetic retinopathy) With NPDR, tiny blood vessels leak, making the retina swell. When the macula swells, it is called macular edema. This is the most common reason why people with diabetes lose their vision. Also with NPDR, blood vessels in the retina can close off. This is called macular ischemia.
What is the prognosis of neurodegenerative diabetic retinopathy (NPDR)?
Patients with severe NPDR have a 52% risk of developing PDR within 1 year, are at a high risk of disease progression and permanent vision loss, and are most likely experiencing neuropathy elsewhere.
What should I do if I have mild NPDR?
Use fundus photography, if available, for easier future comparison. Patients with mild NPDR do not need to be referred to a retina specialist unless you are concerned about or have confirmed a diagnosis of DME (see The 411 on DME ).
What is NPDR in the eye?
In this more common form — called nonproliferative diabetic retinopathy (NPDR) — new blood vessels aren't growing (proliferating). When you have NPDR , the walls of the blood vessels in your retina weaken. Tiny bulges protrude from the walls of the smaller vessels, sometimes leaking fluid and blood into the retina.
Can NPDR be cured?
Often, the hemorrhage will clear by itself. Treatment: The main treatment for NPDR is laser photocoagulation for macular edema. Many patients with significant macular edema are asymptomatic with good vision.
Can NPDR be reversed?
Can DR be treated/reversed? Fortunately, diabetic retinopathy is preventable and also treatable. Maintaining blood sugar at an optimal level can help to prevent this serious condition. As controlled diabetes can also lead to diabetic retinopathy, it is advised to have your eyes examined regularly.
What are the 4 stages of diabetic retinopathy?
The four diabetic retinopathy stages are classified as mild, moderate, and severe nonproliferative and proliferative.
Can glasses help diabetic retinopathy?
This blurred vision cannot be fixed with glasses. With further damage to the retinal blood vessels, the retina will become oxygen depleted. This results in the growth of abnormal new blood vessels, a condition known as neovascularization.
What foods are good for diabetic retinopathy?
Diabetic Retinopathy & The Best Foods for Eye HealthVitamin A. Vegetables: Sweet potato, collard greens, turnip greens, kale, Swiss chard, spinach, romaine, squash, carrot, red pepper, and salmon. ... Vitamin C. Vegetables: Broccoli, spinach, kale, Brussel sprouts, cauliflower, sweet potatoes, winter squash. ... Vitamin E. ... Zinc.
What vitamins are good for diabetic retinopathy?
Optimal combinations of vitamins B1, B2, B6, L-methylfolate, methylcobalamin (B12), C, D, natural vitamin E complex, lutein, zeaxanthin, alpha-lipoic acid, and n-acetylcysteine are identified for protecting the retina and choroid. Certain medical foods have been successfully used as therapy for retinopathy.
Does laser surgery cure diabetic retinopathy?
Laser surgery is often helpful in treating diabetic retinopathy. A beam of laser light is focused on the damaged retina. Small bursts of the laser's beam seal leaking retinal vessels to reduce macular edema. This is called photocoagulation.
Can lowering blood sugar improve vision?
Prevent or Delay Eye Diseases Over time, high blood sugar not only damages blood vessels in your eyes, it can also affect the shape of your lenses and make your vision blurry. Keep your blood pressure and cholesterol levels in your target range to lower your risk for eye diseases and vision loss.
How do you stop diabetic retinopathy from progressing?
You can reduce your risk of developing diabetic retinopathy, or help stop it getting worse, by keeping your blood sugar levels, blood pressure and cholesterol levels under control. This can often be done by making healthy lifestyle choices, although some people will also need to take medication.
Can you regain vision after diabetic retinopathy?
Damage caused by diabetic retinopathy is typically permanent. This condition isn't fully reversible, but some treatments may help bring some of your vision back. While treatments aren't likely to return your vision, your eye doctor can help prevent your vision from worsening.
What is the new drug for diabetic retinopathy?
By Andrew Briskin. The FDA approved Beovu (brolucizumab) to treat diabetic macular edema for people with type 1 or type 2 diabetes. This medication could potentially help you or someone you love protect against diabetes-related vision loss.
Is diabetic blindness permanent?
Diabetic eye screening the condition can cause permanent blindness if not diagnosed and treated promptly. screening can detect problems in your eyes before they start to affect your vision. if problems are caught early, treatment can help prevent or reduce vision loss.
Can vision be restored from diabetic retinopathy?
Treating diabetic retinopathy can repair damage to the eye and even prevent blindness in most people. Treatment can start before your sight is affected, which helps prevent vision loss. Options include: Laser therapy (also called laser photocoagulation).
Can diabetic retinopathy heal itself?
There is no cure for diabetic retinopathy. But treatment works very well to prevent, delay, or reduce vision loss. The sooner the condition is found, the easier it is to treat. And it's more likely that vision will be saved.
Can solar retinopathy be fixed?
There is no effective medical treatment to cure solar retinopathy. In some cases, vision may improve without treatment over a period of weeks or months. But often, vision loss from solar retinopathy or a retina burn is permanent.
Classification Of Nonproliferative Diabetic Retinopathy
The modified Airlie House classification has been used to classify nonproliferative diabetic retinopathy (NPDR) since the Diabetic Retinopathy Study (DRS) and Early Treatment Diabetic Retinopathy Study (ETDRS).
Helpful Tips
Look at images. Lots of them. While the BCSC and the AAO PPP provide very helpful charts and definitions for grading the severity of diabetic retinopathy, there weren't a lot of images provided for helping know exactly how to grade NPDR.
Classification and Management (1-7)
The following table is adapted from multiple sources. I was able to find some images available for linking under the Creative Commons license, which will hopefully help illustrate each stage of NPDR. Obviously, the management of these stages will differ if there is the presence of any macular edema or clinically significant macular edema.
What Happens When You Have Diabetic Retinopathy?
You can have diabetic retinopathy and not know it. This is because it often has no symptoms in its early stages. As diabetic retinopathy gets worse, you will notice symptoms such as:
Can Diabetic Retinopathy Go Away?
Your treatment is based on what your ophthalmologist sees in your eyes. Treatment options may include:
What is PDR in diabetics?
PDR (proliferative diabetic retinopathy) PDR is the more advanced stage of diabetic eye disease. It happens when the retina starts growing new blood vessels. This is called neovascularization. These fragile new vessels often bleed into the vitreous. If they only bleed a little, you might see a few dark floaters.
What is the purpose of fluorescein angiography?
Fluorescein angiography or OCT angiography helps your doctor see what is happening with the blood vessels in your retina. Fluorescein angiography uses a yellow dye called fluorescein, which is injected into a vein (usually in your arm). The dye travels through your blood vessels. A special camera takes photos of the retina as the dye travels throughout its blood vessels. This shows if any blood vessels are blocked or leaking fluid. It also shows if any abnormal blood vessels are growing. OCT angiography is a newer technique and does not need dye to look at the blood vessels.
What is the cause of vision loss?
Diabetic retinopathy is an eye disease caused by diabetes. Damaged blood vessels and abnormal new ones can cause vision loss. People with diabetes can have an eye disease called diabetic retinopathy. This is when high blood sugar levels cause damage to blood vessels in the retina. These blood vessels can swell and leak.
What is the procedure to remove a PDR?
If you have advanced PDR, your ophthalmologist may recommend surgery called vitrectomy. Your ophthalmologist removes vitreous gel and blood from leaking vessels in the back of your eye. This allows light rays to focus properly on the retina again. Scar tissue also might be removed from the retina.
What happens if you have NPDR?
When that happens, blood cannot reach the macula. Sometimes tiny particles called exudates can form in the retina. These can affect your vision too. If you have NPDR, your vision will be blurry.
What is the treatment for DME?
Historically, patients with DME and CSME were treated with either focal laser photocoagulation of the macula or intravitreal injections of anti-VEGF agents. 1 Most retina specialists no longer perform laser treatment in these patients because it causes more scarring and overall permanent loss of vision compared with anti-VEGF treatment (Figure 1). Intravitreal injections of anti-VEGF agents have become the first line of treatment for these patients and generally resolves the CSME (Figure 2). 4
What is a DME?
Patients with diabetic macular edema (DME) exhibit retinal thickening within 2 disc diameters (DDs) of the center of the macula . 1-4 It is considered clinically significant macular edema (CSME) if one of the conditions below is met.
What is the treatment for peripheral neovascularization?
Peripheral neovascularization is usually treated with laser panretinal photocoagulation (PRP, Figure 4). 7 They also often receive anti-VEGF intravitreal injections that may be performed in conjunction with PRP. 7
What type of diabetes was treated with laser PRP in the periphery for PDR in both eyes?
Figure 4. This patient with type 2 diabetes was treated with laser PRP in the periphery for PDR in both eyes.
What is the 4:2:1 rule?
These patients have intraretinal hemorrhages (> 20 in each quadrant), venous beading in two or more quadrants, or an IRMA in one or more quadrants (Figure 3). 2,5-7 This is known as the 4:2:1 rule. These findings must be in the absence of neovascularization, which would indicate PDR.
How thick is the retina?
Thickening of the retina is 500 µm or less (1/3 DD) from the center of the macula. Hard exudates are 500 µm or less (1/3 DD) from the center of the macula with thickening of adjacent retinal tissue.
Why is it important for optometrists to collaborate with PCPs?
As the number of US patients with diabetes grows , it is important for optometrists to collaborate with PCPs, endocrinologists, and retina specialists on managing these patients’ disease. This teamwork, combined with effective communication among caregivers and with patients, will enhance the care that they receive.
Overview
Diabetic retinopathy (die-uh-BET-ik ret-ih-NOP-uh-thee) is a diabetes complication that affects eyes. It's caused by damage to the blood vessels of the light-sensitive tissue at the back of the eye (retina).
Symptoms
You might not have symptoms in the early stages of diabetic retinopathy. As the condition progresses, you might develop:
Causes
In the early stages of diabetic retinopathy, the walls of the blood vessels in your retina weaken. Tiny bulges protrude from the vessel walls, sometimes leaking or oozing fluid and blood into the retina. Tissues in the retina may swell, producing white spots in the retina.
Risk factors
Anyone who has diabetes can develop diabetic retinopathy. The risk of developing the eye condition can increase as a result of:
Complications
Diabetic retinopathy involves the growth of abnormal blood vessels in the retina. Complications can lead to serious vision problems:
Prevention
You can't always prevent diabetic retinopathy. However, regular eye exams, good control of your blood sugar and blood pressure, and early intervention for vision problems can help prevent severe vision loss.
