A new life without glasses
Diabetes has unfortunately become a common condition today. It puts a strain on the entire body and affects numerous functions. One of the frequent chronic complications that affect patients with diabetes is eye disease, specifically diabetic retinopathy. This serious condition affects the blood vessels of the retina and is the leading cause of blindness among diabetics in developed countries.
On November 14, we observe World Diabetes Day, and in the field of ophthalmology, we would like to remind everyone that diabetes significantly impacts eye health.
"Currently, we are unfortunately dealing with a so-called under-treated population of diabetics. The number of patients with diabetes in the Czech Republic is approaching one million, but only a small percentage of them see eye specialists. Neglected prevention leads to diabetics arriving at eye specialists too late, often with retinal changes that can no longer be corrected," says Dana Fillová, MD, a specialist in retinal and vitreous treatment at Eye Centre Prague.
Currently, over 100,000 people with diabetic retinopathy are recorded in the Czech Republic.
Diabetic retinopathy is a serious condition affecting the blood vessels of the retina. High blood sugar levels cause blockage and damage to the small vessels that weave through the retina, leading to impaired blood flow to the retina. In another form of diabetic retinopathy, the vessels in the retina become "leaky," allowing fluid to escape and causing swelling of the retina. Insufficient blood flow and swelling then destroy the ability to see. The eye attempts to remedy the situation by growing new vessels, but these are of poor quality, rupture, and can lead to retinal detachment.
Diabetic retinopathy can indeed cause permanent blindness in patients; it is the leading cause of blindness among diabetics in developed countries. Its occurrence is individual, but it typically develops after several years of the disease. However, complications can unexpectedly arise much earlier.
"The insidious nature of diabetic retinopathy lies primarily in its subtlety. Initially, it may not present any noticeable symptoms, and only in the advanced stages does it manifest as worsening vision, which can no longer be corrected, only slowed down. Today, we have modern diagnostic methods, such as OCT angiography (retinal scanning), which can detect the initial stage of diabetic retinopathy even before it is potentially visible during a fundus examination. That is why regular annual preventive check-ups are so important, even if the patient does not perceive any deterioration in their vision," explains Dana Fillová.
The foundation of treatment and prevention for diabetic retinopathy is achieving and maintaining optimal diabetes management and controlling other risk factors such as high blood pressure and elevated cholesterol levels. However, if the disease progresses to an advanced stage, modern medicine comes into play, such as laser therapy.
While surgical procedures cannot improve vision, they help slow down and stabilize the progression of the disease. The goal of treatment is to seal off non-perfused areas of the retina and prevent leakage from the vessels. A thin laser beam is used to treat the affected areas during the surgical procedure. Laser treatment is performed on an outpatient basis and takes only a few minutes.
Patients can also benefit from biological treatment for the retina. In individuals with diabetic retinopathy, diabetic macular edema may occur, leading to bleeding and swelling on the retina due to leaking vessels. If previous laser therapy fails, biological treatment using anti-VEGF agents is initiated.
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