According to statistics provided by Hospiten, one third of the diabetic population will end up suffering some degree of diabetic retinopathy. This disease occurs because of high blood sugar levels that cause damage to the blood vessels in the retina and can cause vision loss.
Retina and Vitreous specialist and head of the Hospiten Rambla Retina Unit, Alicia Pareja Rios, points out that "there are people with diabetes who can have diabetic retinopathy and not know it since they usually have no symptoms in the early stages".
As the disease progresses symptoms may be noticed like a greater number of floaters, blurred vision, fluctuating vision, white or dark areas in the field of vision, poor night vision or notice that colors are dimmed or dulled.
According to Dr. Pareja Rios, diabetic retinopathy can be prevented with certain healthy lifestyle habits and it can be detected early through the Canary Health Service’s RETISALUD program, or by having an ophthalmology check up.
Dr. Pareja explains that there are two degrees of involvement: on the one hand, non-proliferative diabetic retinopathy (RDNP), which can be mild, moderate or severe and, on the other hand, proliferative diabetic retinopathy (RDP), which is the more advanced form and the most frequent cause of blindness in patients of active working age (from 20 to 65 years of age).
In an ophthalmologic check up, according to the specialist, it is also evaluated whether the macula, the most important area of the retina that is responsible for visual acuity, is affected or not. Dr. Pareja stresses that “you can have non-proliferative diabetic retinopathy (RDNP) with macular involvement and, that causes problems in your eyesight or you can have RDNP without macular involvement, so you would not have visual difficulty. Also, it is possible that the patient may have proliferative diabetic retinopathy (RDP) without macular edema, which is a very advanced stage and have no visual difficulty or have RDP with macular involvement and, consequently, the patient would not see well,” she clarifies.
However, diabetes is not the only cause of macular edema because, as the ophthalmologist states, the condition is also present in patients with retinal venous thrombosis or with intraocular inflammation, although she recognizes that diabetes is undoubtedly the most frequent cause in our environment. For this reason, to reduce the chances of suffering from this type of eye damage, the doctor recommends, “improving metabolic controls, that is, blood glucose levels (blood sugar) and also improving blood pressure, avoid obesity and a sedentary lifestyle”.
Regarding treatment, the retina specialist explains that until a decade ago the only treatment available was laser. However, the sector currently uses intravitreal pharmacotherapy, that is, drugs that are injected into the eye, and which can be long-acting anti-angiogenic and corticosteroid drugs.
In addition, Dr. Pareja states that, in the most advanced cases in which there is significant bleeding (vitreous hemorrhage) or retinal detachment, retinovitreal surgery must be performed. At this point, the specialist explains that, although all surgeries involve risks, in those where surgery is expressly indicated, not operating may pose even greater risks.
Thanks to these treatments, the patient’s sight is usually recovered, although Dr. Pareja Rios insists on the importance of taking several factors into account for a really effective recovery, like keeping blood sugar under control and monitoring the patient's blood pressure. This is also crucial, she emphasizes, "in avoiding a repetition of the condition as much as possible". "Diabetes is the pandemic of our century - we have to return to healthy eating habits, that is, eating fruit, vegetables, grains ... in short, to the Mediterranean diet”, recommends the specialist.