Eye disorders caused by Diabetes
Diabetic retinopathy is a result of vascular changes of the retina of persons suffering from diabetes. It is the most frequent cause blindness of adults between 20 and 65 years. The macular edema is another eye disorder that may be caused by diabetes. The innovative treatment strategy of our senior surgeon Dr. H. Kaymak, who treats the diabetic macular edema also with a combination therapy, has now been confirmed by a scientific study, about which one of the most important German newspaper - the Frankfurter Allgemeine Zeitung - wrote an article in January 2011. Dr. H. Kaymak was a long-term senior physician at a large vitreous body/retina clinic, and also today he works as senior physician at the eye clinic of the Marien Hospital Düsseldorf. He has high experience in this field, and he also presents his treatment results at important expert meetings worldwide.
Diabetic retinopathy and its effects.
What is diabetic retinopathy?
As a metabolic disease, diabetes causes changes of blood vessels by and by, which could correspondingly result in damage to the retina and impairment of vision as well as blindness. Diabetes-related vascular changes of the retina may have a vasoconstrictive effect so that the photoreceptor cells are not sufficiently supplied any more. Furthermore, fluid may leak from the vascular walls and damage the surrounding tissue. The disease progresses from a non-proliferative to a proliferative stage; furthermore, there is the possibility of a diabetic maculopathy which affects the macula as point of sharpest vision in the eye.
The early stage: the non-proliferative retinopathy (NPDR).
Early stage
The effects of the early stage - the so-called non-proliferative stage - of retinopathy on the retinal vessels include bleedings, micro-aneurysms (vasodilation) and fat infiltrations in the surrounding tissue. This results in damage to retina or macula without immediate worsening of vision. At such stage the diabetic retinopathy can still be stopped.
The late stage: the proliferative retinopathy (PDR).
Late stage
If more and more blood vessels are blocked, then the body starts to respond to such decreased supply by forming new blood vessels. At such advanced stage of proliferative retinopathy, new vessels grow into the vitreous body - just like with the vitreous body disease - and cause bleedings and detached retina. Then, vision will suddenly worsen. The symptoms of proliferative retinopathy include blurred or distorted perception.
Diabetic maculopathy - a special field of Dr. Kaymak
The damage may also pass over to the macula, i.e. to the point of sharpest vision, and may correspondingly result in destruction of the central photoreceptor cells. If treatment of the disease is initiated only at such stage, then this may result in continuous and significant loss of vision, and finally also in blindness. Our senior surgeon Dr. H. Kaymak very successfully uses innovative treatment strategies since approx. 2008 that combine laser treatment and injection of anti-VEGF drugs. This strategy has now been confirmed in a scientific study in 2010. (PDF, 4.3MB )
Only annual examinations may prevent continuous worsening of vision.
Progression of the disease can only be prevented by annual examinations and early treatment. If diabetes-related changes of the eye already occurred in the past, then the examination should be made semi-annually or quarterly.
Immediate treatment may stop vascular changes during the early stage.
If one of the regular examinations for diabetic eye disorders detects an initial retinopathy, then the change of the eye vessels can be stopped in most cases by means of out-patient laser treatment or combined therapy before onset of vision impairment.
However, at the late stage only an extensive surgical intervention may be promising.
If the disease advanced to such a degree that the first symptoms become perceptible, then continuous vision impairment up to blindness might only be prevented by a surgical intervention. Extent of treatment and the share of vision to be protected depend on an as-early-as-possible diagnosis of the disease.