Diabetic retinopathy: prevention and treatment options

14/11/2024

Diabetes can significantly affect eye health, leading to complications such as diabetic retinopathy. This condition is one of the main causes of severe visual acuity loss in adults. Retinopathy occurs when high blood glucose levels damage the retinal blood vessels, causing oedema in the central area of ​​the retina, known as the macula, or the abnormal growth of new vessels. Without proper treatment, the lesions can worsen, leading to progressive or, in advanced cases, sudden vision loss.

Prevention

Prevention is crucial to minimizing the risk of developing diabetic retinopathy and other vision problems associated with diabetes. The main preventive measures include:

• Strict blood sugar control. Keeping blood sugar levels within the recommended range is essel. The use of medications and an adequate diet help reduce the chances of eye damage.
• Managing blood pressure and cholesterol. High blood pressure and high cholesterol levels increase the risk of diabetic retinopathy. Controlling these factors can help protect retinal blood vessels.
• Regular eye exams. People with diabetes should undergo annual eye exams or more frequent ones if they already have some degree of retinopathy. These check-ups enable early detection of retinal changes, allowing for timely and appropriate treatment.

Treatment

In its early stages, diabetic retinopathy may not present symptoms. However, as the condition progresses, treatments are essential to slow the progression of the disease and preserve vision. Some treatments include:

• Intravitreal injections. These are used to manage the primary cause of decreased visual acuity affected patients by reducing macular oedema. Medications that block VEGF (vascular endothelial growth factor) are injected into the eye to address this condition. Examples of these drugs include ranibizumab, aflibercept, and faricimab. In certain cases, a slow-release dexamethasone device may also be injected.
• Laser photocoagulation. This treatment is performed to reduce the risk of intraocular bleeding in advanced cases of retinopathy.
• Vitrectomy. In severe cases, surgery  may be performed to remove the pathological vitreous gel and complete the laser treatment. This is an outpatient procedure done under local anaesthesia.

In addition to medical treatments, adopting a healthy lifestyle is essential. Maintaining a balanced diet and engaging in regular physical activity are effective preventive strategies. Reducing the consumption of sugars, saturated fats, and processed foods can help control diabetes and, in turn, protect eye health.

Diabetic retinopathy is a manageable condition if detected and treated early. A proactive approach, including regular eye check-ups and good glycaemic control, can help patients minimize the risk of eye complications and maintain their quality of life.

Dr. Santiago Abengoechea, ophthalmologist at the Barraquer Ophthalmology Centre