Transcript Diabetic Retinopathy

Diabetic Retinopathy
By: Marc Wentz, Regina Carson, Jonathan Nissen,
CydneyWilliams
Diabetic Retinopathy Facts
What is diabetic retinopathy?
Diabetic retinopathy is a complication of diabetes that occurs when
the disease damages tiny blood vessels inside the retina. Elevated
levels of blood glucose harm these blood vessels, usually causing
blindness in both eyes.
Symptoms and Functional
Implications
•Stage one, mild non-proliferative retinopathy. Swelling in the retina’s blood vessels.
•Stage two, moderate non-proliferative retinopathy. Some blood vessels that nourish the retina are
blocked.
•Stage three, severe non-proliferative retinopathy. Many more blood vessels are blocked and deprive
the retina of blood supply. This sends signals to the body to grow new blood vessels for nourishment.
•Stage four, proliferative retinopathy. Signals sent by the retina for nourishment trigger growth of new
blood vessels but they are fragile and abnormal as they grow along the retina and surface of the
vitreous gel inside the eye. These blood vessels have a thin wall and may leak, causing severe or total
vision loss.
•Swelling, fluctuating vision, eye floaters and spots, blurry or distorted vision, eye pain and cataracts.
Diabetic Retinopathy Treatments
The best treatment is prevention. Controlling blood
sugar and regular ophthalmology visits significantly
reduce the risk of long-term vision loss. Those with type
1 diabetes should be examined within five years of
diagnosis. Those with type 2 diabetes should be
examined at the time they are diagnosed and then once
a year after.
Treatments for Vision Loss Due to Diabetic
Retinopathy
Injections of anti-VEGF
Injections of anti-VEGF medication can stop the growth of new
blood vessels and subsequent bleeding. VEGF builds new blood
vessels and causes regression of fragile and abnormal blood
vessels. This is important because fragile and abnormal blood
vessels may leak fluid or bleed, which will swell retinal tissue and
affect vision.
Other Treatments for Vision Loss
Laser Surgery
The laser is focused on all parts of the retina except the macula.
The treatment shrinks abnormal new vessels and prevents
future growth. The procedure will also decrease the chance of
vitreous bleeding or retinal distortion. Of note is the fact that
laser surgery does not cure diabetic retinopathy or prevent
further vision loss.
Other Treatments (con’t)
Vitrectomy
A microsurgical procedure that replaces the blood-filled
vitreous with a clear solution. The procedure also prevents
further bleeding by removing the abnormal vessels. If the
retina is detached, it can be repaired during the procedure.
Case Study
Don is an 18 year old male with Proliferative Diabetic Retinopathy (PDR). The onset of Don’s PDR was early in
life, approximately eight years after being diagnosed with Type 1 diabetes. The medical report states that
controlling Don’s diabetes with the use of insulin was a struggle due to his lack of motivation for self-maintenance
and constant defiance of prescribed treatment. In addition to this, Don’s parents chose to remain uneducated about
his condition and never pushed him to maintain or keep up with his treatment of the disease. Several months ago,
Don began complaining of blurred vision and spots floating in and around his visual field. Visual tests revealed
impaired acuities at near and at distance. In addition, confrontational visual field testing showed a slight reduction
in peripheral vision at about 1 o’clock temporally on both sides. Finally, an initial examination of Don’s retinas
with a direct ophthalmoscope showed hemorrhaging blood vessels in both eyes. Due to the advanced progression
of Don’s condition, the doctor recommended laser photocoagulation to seal off the leaking blood vessels and
stabilize the vision loss. Within weeks, Don received the procedure and though it went as planned, Don was
informed that the photocoagulation was just the first step in treating his PDR. Don was fitted with glasses to
correct his acuities and regular visits to the eye doctor help Don monitor the progression of the disease. Since his
surgical intervention, Don meets regularly with a number of individuals to help manage his diabetes, which is
paramount in preventing further vision loss and damage to his eyes. With the assistance of his ophthalmologist, low
vision specialist, primary care physician, and social support groups, Don is managing his health and taking a
proactive approach to preventing further health concerns. At this time, Don does not utilize any low vision devices
to assist him with activities of daily living and is able to maintain a good quality of life while living with PDR.
A Parent’s Guide to Diabetic Retinopathy
Objective
Provide a brochure of helpful information about Diabetic Retinopathy
to parents of children living with diabetes.
Parents Guide Cont.
Topics
•What is Diabetic Retinopathy
•Who is at rick
•What are some symptoms
•What is the treatment
•Discussing Diabetic Retinopathy with Children
•Empowering children living with Diabetic Retinopathy
Parents Guide Cont.
What is Diabetic Retinopathy
•Common diabetic complication of the eye caused by changed in the
blood vessels of the retina
Who is at risk
•All people with diabetes – Both type 1 and Type 2
•Longer a person lives with diabetes the greater the risk of
developing diabetic retinopathy
Parents Guide Cont.
What are some symptoms
•Blurred vision
•Sudden loss of vision in one eye
•Seeing rings around lights
What are some treatments
•Mild cases, no treatment
•Eye exams are critical for monitoring progression
•Treatments for severe cases
Parents Guide Cont.
Discussing Diabetic Retinopathy with children
•Be positive
•Honest
•Informative age level information
Empowering children living with Diabetic Retinopathy
•Focus on the day-to-day
•Diet
•Exercise
•Life skills
More resources for DR
American Society of Retina Specialists
http://www.asrs.org/patients/retinal-diseases/3/diabetic-retinopathy
-This site explains symptoms, treatment options, prevention, risk factors and what to expect
when learning about Diabetic Retinopathy.
*American Diabetes Association
http://www.diabetes.org/living-with-diabetes/complications/eye-complications/
-This site is full of information all about diabetes, including eye complications.
*National Eye Institute
http://www.nei.nih.gov/health/diabetic/retinopathy.asp
-Complete explanation of Diabetic Retinopathy with pictures, diagrams and tons of valuable
information.
Helpful Information for Parents
Diabetic Retinopathy Brochure for Parents
A few more facts…
These are the same two scenes. The one on the left is someone’s view
who has normal vision. The one on the right is the view from
someone with Diabetic Retinopathy.
How should the eye look?
Conclusion
Diabetic retinopathy is a leading cause of new onset
blindness in adults in the United States. Effective
treatments are available to preserve vision for those who
may be at risk of losing it. The best time for treatment is
before any vision has been lost.
Additional References
http://nihseniorhealth.gov/diabeticretinopathy/whatisdiabeticretinopathy/0
1.html
http://www.allaboutvision.com/conditions/diabetic.htm
http://www.joslin.org/info/Diabetic_Retinopathy_What_You_Need_to_K
now.html