Diabetic retinopathy, also known as diabetic eye disease, is when damage occurs to the retina due to diabetes. It can eventually lead to blindness. It is an ocular manifestation of diabetes, a systemic disease, which affects up to 80 percent of all patients who have had diabetes for 10 years or more. Despite these intimidating statistics, research indicates that at least 90% of these new cases could be reduced if there were proper and vigilant treatment and monitoring of the eyes. The longer a person has diabetes, the higher his or her chances of developing diabetic retinopathy. Each year in the United States, diabetic retinopathy accounts for 12% of all new cases of blindness. It is also the leading cause of blindness for people aged 20 to 64 years. In 2012, 29.1 million Americans, or 9.3% of the population, had diabetes. Approximately 1.25 million American children and adults have type 1 diabetes. Undiagnosed: Of the 29.1 million, 21.0 million were diagnosed, and 8.1 million were undiagnosed. Prevalence in Seniors: The percentage of Americans age 65 and older remains high, at 25.9%, or 11.8 million seniors (diagnosed and undiagnosed). New Cases: The incidence of diabetes in 2012 was 1.7 million new diagnoses/year; in 2010 it was 1.9 million. Prediabetes: In 2012, 86 million Americans age 20 and older had pre diabetes, this is up from 79 million in 2010. Deaths: Diabetes remains the 7th leading cause of death in the United States in 2010, with 69,071 death certificates listing it as the underlying cause of death, and a total of 234,051 death certificates listing diabetes as an underlying or contributing cause of death.
Light mask treatment is designed to be worn at night, to deliver a precise dose of light therapy during a patient?s normal hours of sleep. It comes in two parts ? a plastic ?Pod? part, which is inserted into a soft cushioned Fabric Mask. The Pod contains the light sources which, when worn, emit light into the eyes through closed eyelids. Nothing is inserted into the eyes ? the treatment is non-invasive. The mask is programmed to administer the correct dose of light each night as part of a continuing therapy. The colour of the light has been specifically chosen as the most effective for the treatment of Diabetic Retinopathy. The light may initially appear bright when the mask is first worn, but the eyes adjust within a few minutes as the brain learns to ignore the light, by what is known as the Troxler effect. The light from the mask stops the retina from dark adapting, which is thought to affect Diabetic Retinopathy. Laser photocoagulation can be used in two scenarios for the treatment of diabetic retinopathy. It can be used to treat macular edema by creating a Modified Grid at the posterior pole and it can be used for panretinal coagulation for controlling neovascularization. It is widely used for early stages of proliferative retinopathy. Modified Grid Laser photocoagulation is treated with low intensity small burns. This helps in clearing the macular edema. Panretinal photocoagulation is also called scatter laser treatment, is used to treat proliferative diabetic retinopathy (PDR). The goal is to create 1,600 - 2,000 burns in the retina with the hope of reducing the retina's oxygen demand, and hence the possibility of ischemia. It is done in multiple sittings. In treating advanced diabetic retinopathy, the burns are used to destroy the abnormal blood vessels that form in the retina. This has been shown to reduce the risk of severe vision loss for eyes at risk by 50%.
Intravitreal triamcinolone acetonide is a long acting steroid preparation. When injected in the vitreous cavity, it decreases the macular edema (thickening of the retina at the macula) caused due to diabetic maculopathy, and results in an increase in visual acuity. The effect of triamcinolone is transient, lasting up to three months, which necessitates repeated injections for maintaining the beneficial effect. Best results of intravitreal Triamcinolone have been found in eyes that have already undergone cataract surgery. Complications of intravitreal injection of triamcinolone include cataract, steroid-induced glaucoma and endophthalmitis. There are good results from multiple doses of intravitreal injections of anti-VEGF drugs such as bevacizumab. Present recommended treatment for diabetic macular edema is Modified Grid laser photocoagulation combined with multiple injections of anti-VEGF drugs. Instead of laser surgery, some people require a vitrectomy to restore vision. A vitrectomy is performed when there is a lot of blood in the vitreous. It involves removing the cloudy vitreous and replacing it with a saline solution. Though not yet commercially available, c-peptide has shown promising results in treatment of diabetic complications incidental to vascular degeneration. Once thought to be a useless byproduct of insulin production, it helps to ameliorate and reverse many symptoms of diabetes. Clinical trials are under way or are being populated in preparation for study at medical centers in Brazil, Iran and the United States. Current trials involve using the patients own stem cells derived from bone marrow and injected into the degenerated areas in an effort to regenerate the vascular system.