Diabetic Retinopathy
Diabetic retinopathy is the most common cause of visual loss in people in the middle, most-productive years of life. As a result of a world-wide increase in obesity, diabetes and it complications have reached epidemic proportions. In diabetes, the blood vessels in the retina become damaged, and develop abnormal leakiness, profound blockage, or both. The consequences of these retinal vascular changes for vision are most severe. In the nonproliferative form of diabetic retinopathy, the abnormal leakiness from the retinal vessels leads to macular edema or swelling, and this produces gradual loss of visual acuity. It is extremely important that patients with diabetes receive screening by a retina specialist, because retinopathy is most treatable at its earliest, and often asymptomatic, stages. The diagnosis requires examination of the retina by ophthalmoscopy through a dilated pupil, and also the use of other tests such as Fluorescein Angiography and Optical Coherence Tomography (OCT). Macular edema is treated with laser, drugs, and occasionally vitreous surgery, and the appropriate choice of therapy is complex.
In other patients with diabetes, the retinal changes evolve into proliferative retinopathy, in which abnormal new blood vessels (neovascularization) grow out of the retina into the vitreous. Far from being helpful, these abnormal new vessels cause enormous problems for the eye and vision, because they bleed and contract, causing severe problems including vitreous hemorrhage and traction retinal detachment. Again, patients with diabetes require lifelong periodic screening examinations, because proliferative retinopathy is usually highly treatable by laser in its early stages. For patients with established visual loss due to vitreous hemorrhage or retinal detachment, surgery is often effective, but the surgery can be quite complex and multiple operations may be needed.
Weill Cornell Eye Associates includes several retina specialists with internationally-recognized expertise in the management of all forms of diabetic retinopathy by laser treatment and vitreoretinal surgery. In addition, the use of wide-field angiography by Optos camera evaluation and Spectral Domain OCT permits the accurate detection and treatment of even the most subtle cases of retinopathy.Schedule an Appointment
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