Diabetic Retinopathy - Dr. David Sia

Patients with diabetes can develop damage to the vessels and the nerves in the retina, and this is called diabetic retinopathy.
There are two main stages of diabetic retinopathy according to severity:
- Non-proliferative diabetic retinopathy (NPDR) ranges from mild to severe.
- Proliferative diabetic retinopathy (PDR) is the advanced stage of diabetic retinopathy where the eye starts growing new and abnormal blood vessels (neovascularisation). These new blood vessels can leak and bleed resulting in vitreous haemorrhage, loss of vision and even retinal detachment.
At any stage, diabetic retinopathy can also cause swelling of the retina responsible for central vision (macula). This is called diabetic macular oedema and results in loss of central vision.
Treatment of diabetic retinopathy involves two parts: medical control and lifestyle modification, and specific eye treatments that can include LASER therapy, intravitreal injection therapy, or vitrectomy surgery depending on the nature of the changes.

Intravitreal injection therapy involves numbing the eye with anaesthetic drops, followed by antiseptic drops to sterilise the surface of the eye. The medication is then delivered into the eye using a very fine needle.
LASER is the use of a very focused beam of light to heat retinal tissue. This procedure is done in the clinic with topical anaesthesia. The patient will experience the sensation of a very bright light and occasionally a slight ache during the treatment.
Vitrectomy is an operation that involves the usage of micro-instruments through the white part of the eye (sclera) to remove the vitreous gel. In the context of diabetes, scar tissue and vitreous haemorrhage may also need to be removed at the same time.