What is Diabetic Retinopathy?
Diabetic retinopathy is a complication from diabetes that affects the retinas in the eyes. The retina contains tissue that is highly sensitive to light. The disease develops as a result of blood vessel damage in the retina, caused by high blood sugar or high blood pressure from diabetes. This damage and can cause swelling from fluid accumulation. The fluid buildup may also stop blood flow and block the blood vessels, interfering with vision and developing into scar tissue (x).
This disease has two stages and while the early stage does not usually cause symptoms, without treatment it progresses into its later stage and the patient suffers more severe symptoms. The condition can even progress to vision loss. Medical researchers report that 7.7 million people in the United States suffer from this disease. Experts further expect this number to reach 14.6 million by 2050 (x).
Causes of Diabetic Retinopathy
Diabetic retinopathy is a complication from diabetes, which interferes with how the body uses and stores glucose. Patients have too much sugar in their blood and it causes damage to the blood vessels, including the ones in the eyes. The blood vessels can leak blood and fluid that builds up in the retina, causing swelling and changes in vision. When fluid accumulates in the retina, it can make it difficult for the eyes to focus, resulting in cloudy or blurry vision (x, x).
Symptoms of Diabetic Retinopathy
There are two main stages of diabetic retinopathy: non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR). In its early stages, the condition doesn’t normally show signs and symptoms. But patients usually notice it when the disease starts to progress and when it starts to interfere with vision (x).
Non-Proliferative Diabetic Retinopathy (NPDR)
Many people with diabetes may also have NPDR without realizing it. It causes swelling in the retina and the macula when blood vessels start to leak. NPDR can also cause macular ischemia, which is when the blood vessels in the retina close off. Then, blood flow cannot reach the macula. This can interfere with vision, causing tiny particles to form in the retina (x).
Proliferative Diabetic Retinopathy (PDR)
NPDR progresses into PDR as the retina grows new blood vessels, a process called neovascularization. But because they are abnormal, the new vessels bleed into the vitreous, the jelly-like substance in the middle of the eye (x), causing patients to see spots floating in their vision. If the bleeding is heavy, it can cause vision loss and form scar tissue that can cause tears in the retina (x).
Patients usually begin to notice symptoms in the later stages, compared to the early stage, as they get worse and more noticeable. Symptoms include (x):
- Fluid accumulation
- Cloudy or blurry vision
- Sudden changes in vision
- Scarring in the eyes
- Sensitivity to light
- Floating spots in the vision
- Seeing faded or washed out colors
- Poor night vision
Diagnosing Diabetic Retinopathy
Many patients with diabetes already have diabetic retinopathy without even realizing it. However, it is important for patients to see an ophthalmologist regularly, even if they do not notice any symptoms. It is equally important to visit a doctor for an exam if the patient does start to notice changes in their vision. Diabetic retinopathy is a serious complication from diabetes that can cause blindness without treatment.
There are several ways to diagnose this condition and look for abnormal blood vessel growth in the retina, bleeding in the vitreous, retinal detachment or swelling in the retina. The doctor may dilate the eyes with drops to widen them. The ophthalmologist will use a special lens to examine the inside of the eye (x). The doctor may also use a fluorescein angiography or optical coherence tomography to examine the eye. Fluorescein is a yellow dye that the doctor injects into a vein and uses a camera to take photos of the retina as the dye flows through the blood. On the other hand, optical coherence tomography uses a machine to scan the retina and detect swelling (x).
Treatment for Diabetic Retinopathy
There are different treatment options for this condition depending on how it affects the patient’s eyes. It’s important to seek treatment as soon as possible to preserve vision and avoid complications.
Controlling Blood Sugar
It’s important for diabetic patients to control their blood pressure and blood sugar to keep the blood vessels healthy. If a patient does not take steps to manage diabetes, it increases the risk of complications, including diabetic retinopathy. Research states that managing diabetes may even reverse vision loss (x).
Patients may also need medication to reduce swelling in the macula and improve vision or slow the progression of vision loss. The doctor may also inject steroid medicine into the eyes to reduce swelling (x).
The patient may also need different forms of surgery to correct the issue. For example, laser surgery can help control swelling in the blood vessels and help keep them from getting swollen again. Patients with advanced PDR may require vitrectomy, a procedure that removes fluid, blood and scar tissue from the leaking vessels so that the retina can focus properly (x).
Living with Diabetic Retinopathy
Preventing Vision Loss
The best way to prevent vision loss is to get prompt treatment. Doctors may detect the condition before it even causes symptoms, so it’s important to get regular eye exams. If there are symptoms, seek medical attention as soon as possible. Patients with diabetes should take care about controlling the condition to avoid diabetic retinopathy as a complication. High blood pressure damages blood vessels all over the body including the eyes.
Since diabetic retinopathy is a result of diabetes, there may be a connection between it and dietary choices, which also plays a role in diabetes. In one study, researchers concluded that a Mediterranean diet and low calorie intake may reduce the risk (x). Patients should control their blood sugar, blood pressure and cholesterol with healthy dietary habits. Maintain a consistent diet of healthy carbs, increase fruit and vegetable intake and limit sodium and alcohol (x). Foods rich in beta-carotene and vitamin A may help preserve vision, such as pumpkin, papaya, oranges, kiwis, sweet potatoes, carrots, leafy green vegetables, eggs and fish. The more color in a fruit or vegetable, the more beta-carotene it contains (x).
Supplements for Diabetic Retinopathy
In addition to lifestyle practices and medical treatment, patients may also help control the condition with natural compounds and nutrients (x). Supplements are a good way to stay healthy, but it’s important to consult a doctor for approval before starting a regimen. They are not a cure or a complete prevention for any medical condition, but they may be able to boost in overall health.
Vitamin A has two different categories, carotenoids and retinoids. Both of them exist in food, but the body can absorb retinoids easier, so they are more common in dietary supplements. Vitamin A is an antioxidant that can help reduce free radicals, unbalanced molecules that cause damage and disrupt body systems. It is a common treatment for illnesses, skin conditions and eye health. Research suggests that vitamin A may be able to improve vision and help treat several different eye diseases. It is present in various foods, but patients can also take vitamin A palmitate powder as a supplement for a consistent dosage. The recommended serving is 30 mg daily, unless a doctor recommends a different dosage.
Vitamin E is a group of fat-soluble antioxidant compounds. Like vitamin A, it can help neutralize free radicals and fight disease, such as cancer or heart disease. Vitamin E deficiency can damage the immune system, weak muscles, neuron degeneration and even retinopathy. Research studies have produced evidence that vitamin E may reduce the risk of age-related vision problems, with the help of vitamin C, zinc and beta-carotene. As a dietary supplement, the recommended dosage for vitamin E powder is 500 to 1,000 mg (about ¼ to ⅓ tsp) daily, if a doctor approves the dosage.
Beta-carotene is a carotenoid, a plant pigment in fruits, vegetables, herbs and spices. The body converts into vitamin A, but it can also improve health on its own. It can help support the reproductive system, immune system and respiratory system. Beta-carotene also promotes eye health and studies claim that it may be able to reduce the progression of age-related macular degeneration, which is a major factor in adult blindness. As a dietary supplement, the recommended dosage for beta-carotene 1% (CWS) powder is 1,300 mg (about ½ tsp) daily, after consulting a doctor.
Ginkgo biloba is a common ingredient in natural medicine practices and health supplements. It is rich in antioxidants and may help fight diseases related to oxidative stress, like inflammatory diseases, Parkinson’s disease and Alzheimer’s disease. Hypertension is also related to oxidative stress and can cause diabetic retinopathy. It may also help with eye diseases specifically, such as glaucoma. The recommended dosage for ginkgo biloba leaf extract powder is 175 mg two or three times a day, or following a doctor’s instructions.
Astragalus is a plant genus with more than 2,000 species, mostly herbs and small shrubs that grow in temperate climates in the Northern Hemisphere. It is a common ingredient in herbal medicine practices in China and Persia. Astragalus supports immune health, cardiovascular health and liver function. It may also help patients suffering from heart disease, arthritis and high blood pressure. The recommended daily dosage for astragalus extract powder is 1,300 milligrams a day. Take the supplement with food and make sure to consult a doctor before adding it to a dietary regimen.
The Bottom Line
Diabetic retinopathy is a complication from diabetes, which damages blood vessels throughout the body. It can also damage the blood vessels in the retina and interfere with vision. Symptoms include blurry or cloudy vision, fluid accumulation, scarring and sensitivity to light. Without treatment, patients can lose their eyesight completely. Treatment options include medication to reduce swelling, laser surgery to shrink the blood vessels and vitrectomy to remove fluid, blood vessels or scar tissue from the eyes. Managing blood pressure and blood sugar can also help manage the condition and possibly even reverse vision damage.
It’s also important to consume a healthy diet rich in nutrients, such as beta-carotene and vitamin A. Natural supplements may also help manage diabetes and promote healthy vision. However, it’s important to consult a doctor before starting a supplement regimen. They do not cure or prevent any disease or illness, but they may help improve overall health.