On the occasion of World Diabetes Day, expert associate of the Center for Laser Eye Surgery “Perfect Vision”, expert for the posterior segment of the eye and vitroretinal surgeon, prof. Dr. Sofija Davidović , author of the text on diabetes and diabetic retinopathy, from her many years of experience as head of the department for the posterior segment of the eye and deputy head of the Clinic for Eye Diseases of the University of Vojvodina in Novi Sad, extracted the most important information about what diabetic retinopathy is, what are the symptoms, consequences of this disease, risk groups and how to treat it.

Diabetes and diabetic retinopathy

Millions of people with diabetes face daily challenges to manage their metabolic state, at home, at work, at school, and in general, in everyday life. They must be aware of their disease, well organized and responsible towards themselves, their family and society, because the diabetes disease with its complications can significantly affect their health, both physical and mental well-being.

World Diabetes Day, November 14 , is celebrated every year in over 160 countries around the world, with the aim of raising the level of importance of prevention, early detection and timely treatment of diabetes and its complications, and to support sufferers in the fight for a better life with diabetes.

What is diabetic retinopathy?

Diabetic retinopathy is an eye health disorder that can cause reduced vision and sometimes even blindness in people who have diabetes.

Diabetes damages all blood vessels in the body and leads to macro- and microvascular complications. It has a particularly bad effect on the blood vessels in the retina (the light-sensitive micron layer of tissue in the back of the eye).

If you have diabetes, it is important to have a comprehensive eye exam at least once a year, with a dilated fundus examination and macular imaging (macular OCT).

Diabetic retinopathy may have no symptoms at first, but if you detect it early, you can take the necessary steps to further protect your vision. Managing your diabetes – with physical activity, a healthy diet and taking your medication regularly – can also help prevent or delay the onset of eye complications and subsequent vision loss.

Cataracts: Diabetics are 2-5 times more likely to develop cataracts, and at a younger age.
Open-angle glaucoma: Diabetes almost doubles the risk.
Dry eye: In diabetics, the secretion of tears is more often reduced and the moistening of the eye surface is disturbed.

What are the symptoms of diabetic retinopathy?

In the early stages, there are usually no symptoms. Later, blood vessels bleed into the vitreous body. It can cause:

Dark, floating spots
Cobweb-like bands
A dark curtain before the eye

Without treatment, permanent damage and blindness can occur.

What other problems can diabetic retinopathy cause?

Diabetic macular edema (DME): blurred central vision, significant decrease in visual acuity.
Neovascular glaucoma: Abnormal blood vessels cause pain and redness.
Retinal detachment: Permanent damage and tractional retinal detachment requiring surgery.

Am I at risk of developing diabetic retinopathy?

Anyone with diabetes (type 1, type 2, gestational) can develop retinopathy. The risk increases with the duration of the disease, especially after ten years and with poor metabolic regulation. People with hypertension, obesity, associated diseases and those who are physically inactive also have an increased risk.

Women with diabetes who become pregnant or women who develop gestational diabetes are at particularly high risk. If you have pre-existing diabetes and are planning to become pregnant or are pregnant, be sure to do a complete examination of the eyes and fundus with dilated pupils.

How is diabetic retinopathy treated nowadays?

The treatment is carried out with modern injections into the depth of the eye and/or the application of laser photocoagulation of the retina. For the most severe forms of the disease, vitrectomy is used, often with diabetic cataract surgery. The results depend on the degree of damage and complications.

Prevention of complications is related to good metabolic regulation and maintaining a stable blood sugar level, along with regular endocrinological controls and conscientious treatment. Preventive and regular examinations by an ophthalmologist are crucial for every patient with diabetes.

Diabetes and diabetic retinopathy