Page 66 - January_2016_Life_In_Naples_Magazine

DIABETES

by Stephen G. Schwartz, MD, MBA blood vessel wall injury.
Progression to moderate nonproliferative retinopathy occurs as some blood vessels that nourish
D iabetes is a common
condition in which high the retina become blocked. In severe nonproliferative retinopathy, many more blood vessels are
blood sugar causes damage blocked, depriving large areas of the retina of their blood supply. These areas of the retina send
to blood vessels throughout signals to the body to grow new blood vessels for nourishment. In the most advanced stage,
the body, including the heart, kidneys, proliferative retinopathy, the signals sent by the retina for nourishment trigger the growth of new,
nerves, and eyes. This type of injury fragile blood vessels. These new abnormal blood vessels can leak, causing hemorrhage formation
to blood vessels in the retina is called and possible retinal detachment which can result in severe vision loss and even blindness. The
diabetic retinopathy, which is the most common cause of vision loss from diabetic retinopathy is diabetic macular edema which
leading cause of blindness in working- can occur at any stage and results from fluid leaking out of damaged blood vessels into the retina
age Americans. In the retina, which is which compromises retinal function.
the tissue that lines the back of the eye,
blood vessels can be viewed directly. By The best way for diabetics to maintain good vision is to have regular eye exams to ensure
dilating the pupil, your retina specialist early detection of diabetic retinopathy and to achieve blood sugar, blood pressure, and cholesterol
is able to examine the retina for signs control. Being aware of any changes in vision or new floaters, should prompt diabetic patients to
of damaged blood vessels and gain pursue an urgent exam by their retina specialist. If a patient is diagnosed with diabetic macular
information about the status of diabetes edema, this can be treated with medications, including bevacizumab (Avastin), ranibizumab
throughout your body. A healthy retina (Lucentis), or aflibercept (Eylea), which are administered directly to the eye. These treatments
is necessary for good vision. Diabetic are also being investigated for proliferative diabetic retinopathy, which would traditionally have
retinopathy can cause permanent vision been managed with laser therapy or perhaps a surgical procedure called a vitrectomy, depending
loss not correctable by glasses. on severity.

All people with diabetes are Remember, the best treatment for diabetic retinopathy is prevention. Blood sugar, blood
at risk for developing diabetic pressure, and cholesterol control are paramount in preventing and minimizing diabetic
retinopathy. The duration of diabetes retinopathy. Early diagnosis is also important. I urge all individuals with diabetes to see their
and the extent of blood sugar, blood retina specialist for a thorough dilated eye exam.
pressure, and cholesterol control are
the most important risk factors for
developing this potentially devastating
condition. The Diabetes Control and
Complications Trial (DCCT) showed
that better control of blood sugar levels
slows the onset and progression of
retinopathy.

Diabetic retinopathy has four stages.
Mild nonproliferative retinopathy is
the earliest stage and begins with the
formation of retinal microaneurysms,
which are small areas of balloon-like
swelling in blood vessels that indicate

66 Life in Naples | January 2016