what is retinopathy?

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Retinopathy is a general term that refers to some form of non-inflammatory damage to the retina of the eye. Most commonly it is a problem with the blood supply that is the cause for this condition. Frequently, retinopathy is an ocular manifestation of systemic disease.

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something with the eye? the retina?? like eye surgery maybe

Please see the webpages on Diabetic Retinopathy.

Diabetic Retinopathy

Definition | Symptoms | Treatment | Clinic Information

Definition

Diabetes can affect sight by causing cataracts, glaucoma, and most importantly, damage to blood vessels inside the eye, a condition known as "diabetic retinopathy". Diabetic retinopathy is a complication of diabetes that is caused by changes in the blood vessels of the retina. When blood vessels in the retina are damaged, they may leak blood and grow fragile, brush-like branches and scar tissue. This can blur or distort the vision images that the retina sends to the brain.

Diabetic eye disease is a leading cause of blindness in the United States. People with untreated diabetes are said to be 25 times more at risk for blindness than the general population. The longer a person has had diabetes, the higher the risk of developing diabetic retinopathy. Fortunately, with regular, proper eye care and treatment when necessary, the incidence of severe vision loss has been greatly reduced. If you have diabetes, your ophthalmologist can help to prevent serious vision problems. For more information about the importance of screening for diabetic retinopathy, click here.

Proliferative Retinopathy describes the changes that occur when new, abnormal blood vessels begin growing on the surface of the retina. This abnormal growth is called neovascularization. If these abnormal blood vessels grow around the pupil, glaucoma can result from the increasing pressure within the eye. These new blood vessels have weaker walls and may break and bleed, or cause scar tissue to grow that can pull the retina away from the back of the eye. When the retina is pulled away it is called a retinal detachment and if left untreated, a retinal detachment can cause severe vision loss, including blindness. Leaking blood can cloud the vitreous (the clear, jelly-like substance that fills the eye) and block the light passing through the pupil to the retina, causing blurred and distorted images. In more advanced proliferative retinopathy, diabetic fibrous or scar tissue can form on the retina.

Macular Edema describes the condition where retinal blood vessels can develop tiny leaks. When this occurs, blood and fluid seep from the retinal blood vessels, and fatty material (called exudate) deposits in the retina. This causes swelling of the retina and is called diabetic macular edema. When this occurs in the central part of the retina (the macula), vision will be reduced or blurred.

Many people with severe, vision-threatening diabetic retinopathy have no symptoms! Regular ophthalmic examinations are crucial to obtaining treatment before it is too late!

Symptoms

Difficulty reading
Blurred vision
Sudden loss of vision in one eye
Seeing rings around lights
Dark spots or flashing lights

NOTE: Pregnancy and high blood pressure may aggravate diabetic retinopathy.
The symptoms described above may not necessarily mean that you have diabetic retinopathy. However, if you experience one or more of these symptoms, contact your eye doctor for a complete exam.

Treatment

In mild cases, treatment for diabetic retinopathy is not necessary. Regular eye exams are critical, though, to monitor any progression. Strict control of blood sugar and blood pressure levels can greatly reduce or prevent diabetic retinopathy.

In more advanced cases, treatment is recommended to stop the damage of diabetic retinopathy and prevent vision loss.

Laser surgery is often helpful in treating diabetic retinopathy. To reduce macular edema, laser light is focused on the damaged retina to seal leaking retinal vessels. For abnormal blood vessel growth (neovascularization), the laser treatments are delivered over the peripheral retina. The small laser scars that result will reduce abnormal blood vessel growth and help bond the retina to the back of the eye, thus preventing retinal detachment. Laser surgery may be performed in your ophthalmologist's office or in an out-patient clinic. Laser surgery can greatly reduce the chance of severe visual impairment.

Intraocular Steroid Injection is a newly emerging treatment for diabetic macular edema. This therapy helps reduce the amount of fluid leaking into the retina, resulting in visual improvement. Due to the chronic nature of diabetic eye disease, this treatment may need to be repeated or combined with laser therapy to obtain maximal or lasting effect.

Cryotherapy (freezing) may be helpful in treating diabetic retinopathy. If the vitreous is clouded by blood, laser surgery cannot be used until the blood settles or clears. In some of these cases retinal cryotherapy may help shrink the abnormal blood vessels and bond the retina to the back of the eye.

Vitrectomy may be recommended in advanced proliferative diabetic retinopathy. Vitrectomy removes the blood-filled vitreous and replaces it with a clear solution. Your ophthalmologist may wait from several months to a year to see if the blood will clear on its own, before going ahead with a vitrectomy. This microsurgical procedure is performed in the operating room.

Retinal repair may be necessary if scar tissue has detached the retina from the back of the eye. Severe loss of vision or even blindness can result if surgery is not performed to reattach the retina.

What Is Your Part In Treatment?

Successful care of diabetic retinopathy depends not only on early treatment by your ophthalmologist, but especially on your attitude and attention to medications and diet. You must maintain blood sugar levels, avoid smoking and watch your blood pressure. Physical activity usually poses no problem for people with background retinopathy. Occasionally, people with active proliferative retinopathy are advised to restrict their physical activity.

Clinic Information
For more information, see the Retina, Uveitis & Ocular Oncology Clinic and the complete Clinic Services listing of the U-M Kellogg Eye Center.

Retinopathy is a side effect of diabetes when anurisms(blood vessels burst) occur at the retina the number one cause of blindness in diabetics.

Diabetic Retinopathy

Overview

Diabetes is a disease that occurs when the pancreas does not secrete enough insulin or the body is unable to process it properly. Insulin is the hormone that regulates the level of sugar (glucose) in the blood. Diabetes can affect children and adults.

How does diabetes affect the retina?

Patients with diabetes are more likely to develop eye problems such as cataracts and glaucoma, but the disease’s affect on the retina is the main threat to vision. Most patients develop diabetic changes in the retina after approximately 20 years. The effect of diabetes on the eye is called diabetic retinopathy.

Over time, diabetes affects the circulatory system of the retina. The earliest phase of the disease is known as background diabetic retinopathy. In this phase, the arteries in the retina become weakened and leak, forming small, dot-like hemorrhages. These leaking vessels often lead to swelling or edema in the retina and decreased vision.

The next stage is known as proliferative diabetic retinopathy. In this stage, circulation problems cause areas of the retina to become oxygen-deprived or ischemic. New, fragile, vessels develop as the circulatory system attempts to maintain adequate oxygen levels within the retina. This is called neovascularization. Unfortunately, these delicate vessels hemorrhage easily. Blood may leak into the retina and vitreous, causing spots or floaters, along with decreased vision.

In the later phases of the disease, continued abnormal vessel growth and scar tissue may cause serious problems such as retinal detachment and glaucoma.

Signs and Symptoms

The affect of diabetic retinopathy on vision varies widely, depending on the stage of the disease. Some common symptoms of diabetic retinopathy are listed below, however, diabetes may cause other eye symptoms.

Blurred vision (this is often linked to blood sugar levels

Floaters and flashes

Sudden loss of vision

Detection and Diagnosis

Diabetic patients require routine eye examinations so related eye problems can be detected and treated as early as possible. Most diabetic patients are frequently examined by an internist or endocrinologist who in turn work closely with the ophthalmologist.

The diagnosis of diabetic retinopathy is made following a detailed examination of the retina with an ophthalmoscope. Most patients with diabetic retinopathy are referred to vitreo-retinal surgeons who specialize in treating this disease.

Treatment

Diabetic retinopathy is treated in many ways depending on the stage of the disease and the specific problem that requires attention. The retinal surgeon relies on several tests to monitor the progression of the disease and to make decisions for the appropriate treatment. These include: fluorescein angiography, retinal photography, and ultrasound imaging of the eye.

The abnormal growth of tiny blood vessels and the associated complication of bleeding is one of the most common problems treated by vitreo-retinal surgeons. Laser surgery called pan retinal photocoagulation (PRP) is usually the treatment of choice for this problem.

With PRP, the surgeon uses laser to destroy oxygen-deprived retinal tissue outside of the patient’s central vision. While this creates blind spots in the peripheral vision, PRP prevents the continued growth of the fragile vessels and seals the leaking ones. The goal of the treatment is to arrest the progression of the disease.

Vitrectomy is another surgery commonly needed for diabetic patients who suffer a vitreous hemorrhage (bleeding in the gel-like substance that fills the center of the eye). During a vitrectomy, the retina surgeon carefully removes blood and vitreous from the eye, and replaces it with clear salt solution (saline). At the same time, the surgeon may also gently cut strands of vitreous attached to the retina that create traction and could lead to retinal detachment or tears.

Patients with diabetes are at greater risk of developing retinal tears and detachment. Tears are often sealed with laser surgery. Retinal detachment requires surgical treatment to reattach the retina to the back of the eye. The prognosis for visual recovery is dependent on the severity of the detachment.

Prevention

Researchers have found that diabetic patients who are able to maintain appropriate blood sugar levels have fewer eye problems than those with poor control. Diet and exercise play important roles in the overall health of those with diabetes.

Diabetics can also greatly reduce the possibilities of eye complications by scheduling routine examinations with an ophthalmologist. Many problems can be treated with much greater success when caught early.

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what is retinopathy?

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