Malaysia is one of leading countries with diabetes prevalence, which also explains the high number population with diabetic eye disease. Diabetic eye disease is a group of eye conditions that can affect people with diabetes.

• Diabetic retinopathy affects blood vessels in the light-sensitive tissue called the retina that lines the back of the eye. It is the most common cause of vision loss among people with diabetes and the leading cause of vision impairment and blindness among working-age adults.

• Diabetic macular edema (DME). A consequence of diabetic retinopathy, DME is swelling in an area of the retina called the macular.

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Causes of Diabetic Eye Disease

When diabetic conditions cause blood vessels in the retina to be damaged,the damaged blood vessels leak fluid and lipids onto the macula (the portion of retina responsible for detailed vision). As the disease progresses, new and fragile blood vessels grow along the retina.

Without timely treatment, these new blood vessels can bleed, cloud vision, and destroy the retina. Left alone, scarring or detachment of the retina may occur.

All individuals with Diabetes, which include pregnant women are at risk of this condition. Those with high blood pressure and high cholesterol are at greater risk of aggravating the condition.

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Symptoms of Diabetic Retinopathy and DME

There are no signs or symptoms in the early stages of diabetic retinopathy. However, in later stages, those with the condition may experience:

• Blurring vision

• Difficulty reading

• Sudden loss of vision in one eye

• Floaters and flashes of light

• Seeing rings around light sources

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How do we diagnose Diabetic Retinopathy  and DME?

• Fundus Examination (the use of a special slit lamp to see the insides of the eye)

• Fundus Viewing – a Consultant Ophthalmologist will examine the retinal to provide an accurate diagnosis

• Fundus Photography – Trained staff utilise a fundus camera to capture an image of the inner eye

• Fundus Fluorescein Angiography (FFA)– a procedure similar to Fundus Photography, but has fluorescein dye injected into the patient, which will travel to the eye and highlight the blood vessels, allowing the ophthalmologist to check for leaking of blood vessels even if there is poor blood supply.
   

Treatment Options

• Diabetes management is important in preventing further loss of sight due to diabetic retinopathy. Additionally, the following procedures can be carried out to repair the damage caused by the condition

• Anti-VEGF Injection Therapy. Anti-VEGF drugs are injected into the vitreous gel to block a protein called vascular endothelial growth factor (VEGF), which can stimulate abnormal blood vessels to grow and leak fluid. Blocking VEGF can reverse abnormal blood vessel growth and decrease fluid in the retina

• Laser Treatment (used to seal or remove abnormal blood vessels and leaking blood vessels)

• Surgery (vitrectomy). A vitrectomy is the surgical removal of the vitreous gel in the center of the eye. The procedure is used to treat severe bleeding into the vitreous, and is performed under local or general anesthesia.

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What can you do?

If you have diabetes you should visit your ophthalmologist regularly to ensure that your retina is healthy, especially diabetic eye disease may be asymptomatic as early stages.

Early detection of the disease is crucial to detect and restore eyesight before permanent damages takes place.

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