Saturday, May 18, 2024

Macular Degeneration Caused By Diabetes

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Preventing Diabetic Macular Edema

Dr. Raymond Iezzi, Jr., Diabetes, Glaucoma & Macular Degeneration

The best prevention for diabetic macular edema is managing your diabetes and following a healthy lifestyle. Maintaining proper blood sugar levels, coupled with keeping your cholesterol and blood pressure in check, is important in preventing diabetic macular edema.

Its also important to get regular eye exams, including the dilated eye exam. This way your healthcare provider can monitor any changes to your vision and check for possible eye damage.

How Diabetes Affects Your Eyes

People with diabetes are at risk of damage to their eyesight. To work properly, the eye needs a constant supply of blood. When control of blood sugar and insulin levels in the body is poor, the blood vessels of the eye become damaged. The blood vessels of the retina are particularly prone to leaking and a condition known as diabetic retinopathy can develop.

People with diabetes should reduce their risk of vision loss by attending their annual diabetic eye screening appointment.

Related Conditions And Causes Of Diabetic Macular Edema

Some conditions closely related to diabetic macular edema include:

The NIHs National Eye Institute provides detailed educational materials for different types of eye diseases and conditions. From fact sheets to webinars, their resources can help you learn more about diabetic eye diseases and how to lower your risk of vision loss.

The ADAs mission is to prevent and cure diabetes and improve the lives of all people affected by the disease. Their site offers useful information about diseases that affect vision as well as stories from patients who are living with diabetes-related eye conditions.

Prevent Blindness is an organization with a mission that echoes its name: to prevent blindness and preserve sight. We especially like their Resources for Low Vision page, which provides links to financial assistance sites, doctor searches, assistive technology products, and more.

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What Is The Macular

The macula is the central bit of the retina . The macula is about 5mm across. It is responsible for our central vision, our colour vision and the fine detail of what we see.

The macula has a very high concentration of photoreceptor cells that send signals to the brain which interprets them as images. The rest of the retina processes our peripheral, or side vision. Damage to the macula can mean losing the ability to read, watch TV or recognise faces.

What Is Diabetic Macular Degeneration

Diabetic Retinopathy

In order to understand what diabetic macular degeneration is, you first need to understand a little about how the eye works. In normal vision, light enters through your cornea as it would through a pane of glass. The light rays are bent by the lens, allowing them to focus on the area at the very back of the of the eye known as the retina.

The retina is lined with millions of very tiny, light sensitive cells. Some of the cells are cone shaped, others are rod shaped. These specialized cells convert light into electrical impulses which are then sent to the brain via the optic nerve, where they are interpreted as images. These cone and rod cells become very densely packed in the center of the retina, in an area called the macula. The macula helps you to see clearly and pick up fine details.

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Macular Degeneration Association Type 2 Diabetes Archives

THE MACULAR DEGENERATION ASSOCIATION, INC. IS A REGISTERED 501 NON-PROFIT CORPORATION. A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE WITHIN THE STATE OR ON THE CONSUMER SERVICES WEBSITE WWW.800HELPFLA.COM .REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE. The Macular Degeneration Association, Inc. is responsible for the content of this website. Its purpose is to provide useful information for persons with macular degeneration, their families, and the general public. This information is neither intended nor implied to be a substitute for professional medical advice relative to your specific medical condition or question. Always seek the advice of your physician or other health care provider for any questions you may have regarding your medical condition. Only your physician can provide specific diagnoses and treatments. The Macular Degeneration Association is recognized by the IRS as a 501 a tax exempt organization. The mission of the organization is to support research to help find a cure for macular degeneration and to improve the lives of all people affected by this disease. All content and works posted on this website are owned and copyrighted by the Macular Degeneration Association. All rights reserved. Copyright 2011 Macular Degeneration Association. All rights reserved.Continue reading > >

Strengths And Limitations Of This Study

  • This study included elderly patients with type 2 diabetes mellitus for 10 years.

  • Variables in this study included potential confounders, such as laboratory data, duration and dose of metformin use and diabetic retinopathy.

  • The subgroup analysis in the early and late age-related macular degeneration and the in-depth investigation in duration-dependent and dose-dependent response patterns were performed.

  • This study was retrospective design with relatively small sample of AMD and lack of analysis of other medication histories.

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How To Prevent Dme

  • Maintaining good blood sugar, blood pressure, and cholesterol control helps prevent DME.
  • Receiving a comprehensive dilated eye exam at least once a year, or more often as directed by the eye doctor.
  • Pregnant woman with diabetes should have a comprehensive dilated eye exam as soon as possible. The eye doctor may recommend additional exams during pregnancy.
  • Maintaining a healthy lifestyle, exercising regularly, and having a healthy diet. Talk to a doctor before starting an exercise program.

Statins And Diabetes Drugs Found To Reduce Risk Of Age

Diabetic Retinopathy, Age-Related Macular Degeneration, and Access to Eye Care

Drugs to control diabetes and lower cholesterol may reduce the risk of developing age-related macular degeneration , a new study suggests.

The study, published in the British Journal of Ophthalmology, saw researchers draw together information from 14 studies to assess whether drugs to lower cholesterol, control diabetes, and dampen down inflammation may help to lessen the risk of developing AMD.

Previous research has shown positive results from these drugs, but findings have been partly contradictory and based on small numbers of participants.

Scientists at the University Hospital Bonn in Germany examined the studies involving almost 40,000 people from the UK, France, Germany, Greece, Ireland, Italy, Norway, Portugal and Russia.

Participants in the studies which included around 9,332 with AMD, were all over the age of 50 and taking at least one type of drug to: lower cholesterol including statins control diabetes including insulin to control inflammation excluding steroids or a drug to treat movement disorders caused by neurodegenerative disease.

Researchers found that people taking drugs to lower cholesterol had a 15% reduced risk of developing AMD compared to those who were not taking the drugs.

Meanwhile, people taking medicine to control diabetes appeared to have a 22% lesser risk.

No such associations were found for the other types of drugs being taken by people involved with the study.

Find out more about the research projects the Macular Society funds.

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What Is Macular Degeneration

Macular degeneration is the breakdown of the light-sensitive cells in the macula, the central part of the retina responsible for sharp, central vision. Age-related macular degeneration is the most common cause of vision loss in people over the age of 55 in the United States. More than 8 million Americans have AMD, and the number is expected to increase as the population ages.

Study Cohort And Patient Selection

This study was approved by the Ethics Committee and Human Subjects Institutional Review Board of Tzu Chi Hospital, Hualien, Taiwan . Among a total of 999,991 subjects between 1 January 1997 and 31 December 2012 in the NHIRD, 104,079 subjects with the diagnosis of diabetes and 895,912 subjects without diabetes were initially enrolled into diabetes and nondiabetes groups, respectively, for the main study cohort. Subjects were excluded from the diabetes group if they were < 50 years old or had AMD before the diagnosis of diabetes. On the other hand, 625,699 subjects < 50 years of age were excluded from the nondiabetes group. To avoid confounding effect of subjects characteristics and comorbidities, the resulting available 71,904 patients with diabetes and 270,213 patients without diabetes were further matched in a 1:1 ratio by age, sex, and Charlson comorbidity index finally, 54,616 study subjects in each of the diabetes and nondiabetes groups were obtained. The index date was defined as the onset date of diabetes. In addition to the main study cohort , the stratified populations with diabetes with DR versus diabetes without DR , and proliferative DR versus nonproliferative DR were also obtained via similar exclusion criteria and matching procedures for the subsequent stratified analysis. The detailed study data flows are described in .

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Ways Diabetes Can Affect Your Eye Health

Nearly 1 person in 25 in the UK has diabetes. If you have diabetes, its important to monitor your eye health increased blood sugar levels can lead to vision problems such as cataracts, glaucoma, and retinopathy.

Diabetes is a disease that affects the way we process food for energy and growth. With all forms of diabetestype 1, type 2 and gestational diabetesthe body has trouble converting sugar in the blood into energy, resulting in a variety of potential health problems.

In this blog we look at some of the diabetes-related vision problems or diseases that might occur:

Is It True That Diabetes Causes Fuzzy Vision

Laser Treatment for Diabetic Macular Edema  Retina Specialist ...

If your fuzzy vision is caused only by hyperglycemia or hypoglycemia, it should clear up with time and proper blood sugar management. Your blood sugar level and, with it, your eyesight may take several weeks to recover to normal. However, its possible that the impact is just transitory. If the fuzzy vision is from damage to the blood vessels and edema, the fuzzy vision could become permanent if not treated quickly.

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How The Eye Works

The eye works by filtering light that hits the eye. The retina is responsible for most of this, converting light into signals that the brain interprets as pictures. The retina requires a blood supply and diabetes sometimes damages these vessels.

When light enters your eye, it does so through the macula, which is the central part of the retina. It is tiny, about the size of a pinhead, but incredibly important. Thanks to the macula, you can read and write, recognize colors and more. The larger part of the retina is only responsible for peripheral vision.

The Prevalence Of Amd In Different Dr Stages Of Non

In non-DM participants, some patients with DR were also staged according to DR. Because moderate NPDR , severe NPDR , and PDR were not combined with wet AMD, it is impossible to count the difference in the prevalence of dry and wet AMD in the different DR stages of non-DM .

Table 4. The prevalence of AMD in different stages of DR with non-DM.

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Treatment For Macular Degeneration

The treatment options for macular degeneration will depend on the stage and type of the disease.

Currently, there is no treatment for dry AMD. However, similar to diabetes, lifestyle changes such as eating a nutritious diet, exercising regularly, and quitting smoking can help. Taking certain supplements may also help prevent or slow the conditions progression.

include :

  • Attending regular eye exam appointments: Many vision problems can develop without noticeable symptoms. As such, it is advisable to see an eye specialist regularly.
  • Controlling blood sugar levels: For individuals with diabetes, managing A1C, blood pressure, and cholesterol levels can help maintain eye health and prevent vision complications.
  • Following a balanced diet: A diet rich in fruits and vegetables, particularly dark leafy greens, can benefit eye health. Consuming fish high in omega-3 fatty acids may also be helpful.
  • Maintaining a moderate weight:Obesity can be a risk factor for macular degeneration and diabetes.
  • Quitting smoking: There are many links between smoking and health conditions, including vision problems and the progression of macular degeneration.
  • Knowing family history: Many eye conditions run in families. Knowing this information can help eye doctors determine a persons risk of vision problems.
  • Wearing protective eyewear and practicing eye safety: Using appropriate eyewear can help protect the eyes.

Additionally, according to the

Wet And Dry Macular Degeneration

Wet Age-Related Macular Degeneration (wet AMD) Explained

In macular degeneration, these very important light sensitive cells begin to break down, slowly deteriorating, causing a gradual loss of vision. In fact, macular degeneration is the leading cause of vision loss among people over the age of 55 in the United States. People with both type I and Type II diabetes are at risk for developing diabetic related macular degeneration. There are two major forms of macular degeneration: wet and dry. The vast majority are the dry form.

Dry macular degeneration causes a gradual loss of central vision. Wet, macular degeneration, on the other hand, is known to be more aggressive, often resulting in severe vision loss. In some cases, the disease can begin as dry, and then progress to wet. For unknown reasons, new blood vessels can form behind the retina, growing into the macula. These blood vessels are extremely fragile, meaning that they leak or rupture quite easily, and can cause severe vision loss.

Common symptoms of Macular Degeneration Include:

  • Trouble recognizing faces
  • A central blind spot that begins to expand
  • Straight lines may appear wavy

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What Is Proliferative Diabetic Retinopathy

Proliferative diabetic retinopathy is the most advanced stage of diabetic retinopathy, and is classified by the growth of new blood vessels on the retina. These blood vessels are abnormal and fragile, and are susceptible to leaking blood and fluid onto the retina, which can cause severe vision loss and even blindness.

If blood leaks onto the retina, patients may begin to notice floaters in their vision, which are actually specks of blood that appear in front of your vision. While floaters can sometimes clear up on their own, it is important to see Dr. Brown as soon as you notice them, as they can recur and lead to severely blurred vision and vision loss.

Patients with proliferative diabetic retinopathy often require laser surgery to treat their condition. This treatment is known as scatter laser treatment and is used to shrink the newly developed abnormal blood vessels. This treatment is usually performed in two or more sessions due to the number of laser burns necessary. Scatter laser treatment is most effective before new blood vessels have started to leak, and may slightly reduce patients color and night vision, while preserving central vision. Severe bleeding may require a vitrectomy, or removal of the vitreous, to remove blood from the center of the eye.

Living With Low Vision

If you or someone you know has lost some sight to DME, low vision aids can help you stay independent. Special training, called vision rehabilitation, can provide skills for living with low vision. A low vision specialist will help determine the right combination of aids for your needs. Ask your eye doctor about the possibility of seeing a low vision specialist.

Low vision aids include:

  • Magnifying glasses, screens and stands
  • Telescopic lenses
  • Large-print newspapers, magazines and books
  • Close-circuit TVs that magnify a printed page on screen
  • Computers and tablets

Living Well with Low Vision is an online resource to educate those with loss of vision on how maintain their independence and quality of life.

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Treatments Of Macular Degeneration Vs Diabetic Retinopathy

Treatment of dry AMD consists of mostly diet and monitoring. Lots of green leafy vegetables, foods low in cholesterol, and taking a good AREDS ocular vitamin. Quitting smoking is one of the most beneficial things you can do.

The treatment for wet AMD is usually a shot of an anti-VEGF medication to stop the formation of the new, fragile blood vessels. Another common treatment uses a light-activated dye that plugs the tiny vessels when activated causing them to atrophy and dyes off.

Diabetic retinopathy treatment can vary from just monitoring your blood sugars and retina with regular eye exams to Photocoagulation laser treatments for severe retinopathy with neovascularization . Injections of the anti-VEGF are also used when there is neovascularization similar to AMD.

How Diabetes Can Affect The Eyes

Eye Diseases

The retina is the light-sensitive layer of cells at the back of the eye that converts light into electrical signals. The signals are sent to the brain which turns them into the images you see.

The retina needs a constant supply of blood, which it receives through a network of tiny blood vessels.

Over time, a persistently high blood sugar level can damage these blood vessels in 3 main stages:

  • background retinopathy tiny bulges develop in the blood vessels, which may bleed slightly but do not usually affect your vision
  • pre-proliferative retinopathy more severe and widespread changes affect the blood vessels, including more significant bleeding into the eye
  • proliferative retinopathy scar tissue and new blood vessels, which are weak and bleed easily, develop on the retina this can result in some loss of vision

However, if a problem with your eyes is picked up early, lifestyle changes and treatment can stop it getting worse.

  • eye pain or redness
  • difficulty seeing in the dark

These symptoms do not necessarily mean you have diabetic retinopathy, but it’s important to get them checked out.

Do not wait until your next screening appointment.

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How Is Diabetic Macular Edema Diagnosed

  • Optical Coherence Tomography With OCT, a special machine scans the retina and provides detailed views of its thickness. It can help measure the amount of swelling in the macula.
  • Fluorescein Angiography A yellow dye is injected into a vein and moves through your blood vessels. Doctors use a special camera to capture images of the retina as the dye travels through its blood vessels. It can help your doctor determine the amount of damage to the macula.
  • Visual Acuity Test This common way to assess vision loss involves using a standardized chart with rows of letters. Youre asked to cover one eye and read the smallest line of letters you can see.
  • Amsler Grid This method is used to test your central vision. You basically look at a grid and report if any parts are missing, distorted, or dark.

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