Diabetic retinopathy refers to the effect of diabetes on the retina. Sugar within the blood can have a damaging effect on the fine blood vessels of the retina. This can lead to leakage of blood and fatty deposits into the retina. Blurred vision can develop if this leakage occurs in the central part of the retina known as the macula. This process is known as diabetic maculopathy or diabetic macular oedema (DMO).
Diabetic maculopathy is one of the leading causes of blindness in the Western working population and early treatment can now reverse visual loss.
A thorough ophthalmological examination is carried out including vision tests, intraocular pressure measurements and an ocular fundus examination. A full fundus examination requires eye drops to dilate the pupil, which can temporarily blur near vision for a few hours.
Special imaging techniques such as Optical Coherence Tomography (OCT), colour fundus photography and fundus fluorescein angiography may be used to assess the degree of swelling and blood oxygen flow to the macula.
Lifestyle changes such as good control of diabetes, high blood pressure, high cholesterol, stopping smoking, taking regular exercise and eating a healthy diet are all important in improving diabetic maculopathy.
Medical treatments for diabetic maculopathy include laser photocoagulation. Gentle laser is applied to the macula region resulting in a reduction of the swelling and preventing further visual loss.
Newer treatments such as delivering anti-VEGF medicines into the vitreous by injection have been shown to reduce the macular swelling and improve vision in diabetic maculopathy. Some patients require a course of treatment but these new medicines have revolutionised the treatment of diabetic maculopathy.