St. George Diabetic Eye Disease Care

St. George Diabetic Eye Disease Retinopathy

Stages of Diabetic Retinopathy in Optometry and Ophthalmology

Nonproliferative & Proliferative Retinopathy

Diabetic Retinopathy tends to appear and progress in stages beginning with Mild Nonproliferative, progressing to Moderate Nonproliferative Retinopathy, further advancing to Severe Nonproliferative Retinopathy and without proper attention developing into the most severe stage, Proliferative Retinopathy.

Mild Nonproliferative Retinopathy

Mild Nonproliferative Retinopathy is the earliest stage of Diabetic Retinopathy. It is characterized by the presence of “dot” and “blot” hemorrhages and “microaneurysms” in the Retina found during your eye examination. Microaneurysms are areas of balloon like swelling of the tiny blood vessels in the Retina caused by the weakening of their wall. Mild Nonproliferative Retinopathy can be present without any change in your vision. Mild Nonproliferative Retinopathy usually does not require treatment unless it progresses or if is accompanied by Diabetic Macular Edema. If you have Mild Nonproliferative Retinopathy, Dr. Graf will make specific recommendations about how often you will need to be reexamined and whether any additional testing might be required.

Moderate Nonproliferative Retinopathy 

Moderate Nonproliferative Retinopathy is the second and slightly more severe stage of Diabetic Retinopathy. During this stage, some of the small blood vessels in the Retina may actually become blocked. The blockage of these tiny blood vessels causes a decrease in the supply of nutrients and oxygen to certain areas of the Retina.

Severe Nonproliferative Retinopathy 

Severe Nonproliferative Retinopathy is the next stage of Diabetic Retinopathy. Severe Nonproliferative Retinopathy is characterized by a significant number of small blood vessels in the Retina actually becoming blocked. As more blood vessels become blocked, it results in areas of the Retina being deprived of nourishment and oxygen. A lack of sufficient oxygen supply to the Retina results in a condition called “Retinal Ischemia”. To attempt to compensate for “Retinal Ischemia”, these areas of the Retina then send signals to the body to stimulate the growth of new blood vessels in order to try and reestablish the supply of oxygen.

Proliferative Retinopathy

Proliferative Retinopathy is the most severe stage of Diabetic Retinopathy and carries a significant risk of vision loss. The Retina responds to a lack of oxygen, or “Retinal Ischemia”, by attempting to compensate for the reduced circulation by growing new, but abnormal blood vessels (a process called “neovascularization”). When Retinal Neovascularization is present, you have progressed into the stage of Diabetic Retinopathy called Proliferative Retinopathy. It might seem that new blood vessel growth or neovascularization is a desirable event, as it will provide the Retina with greater blood flow and thus more oxygen and nutrients. However this is not the case at all. Retinal Neovascularization is formed from new blood vessels that are extremely fragile and tend to break easily and hemorrhage throughout the eye. If left untreated, Proliferative Retinopathy may lead to bleeding into the Vitreous and Retinal Detachment with profound vision loss.

Proliferative Retinopathy is treated with a new option of special medications injected into the back of the eye. This new treatment is highly effective. Additional previous options include either Retinal Laser Photocoagulation Treatment alone or Retinal Laser Photocoagulation Treatment in conjunction with a surgical procedure called a Vitrectomy. During a Vitrectomy, a Surgeon will remove the Vitreous that has been filled with blood or scar tissue.

It may be possible for patients to have Proliferative Retinopathy and Retinal Neovascularization and yet still have good vision. Even if Proliferative Retinopathy and Retinal Neovascularization do not appear to be causing any vision loss, it is critical that they be treated as quickly as possible in order to stop the progression and preserve good vision. The best way to preserve vision for diabetes is to control blood sugar, blood pressure, cholesterol levels, and to have a thorough annual dilated eye examination with retinal photos.

Diabetic Retinopathy is a common eye disease that affects a large number of patients with Diabetes Mellitus. With early detection and treatment, vision loss from Diabetic Retinopathy can be prevented.

Take care of your eyes with a Dilated Ophthalmological Vision Checkup and Eye Exam at Graf Medical Eye Care & Vision Center. Start Protecting Your Vision Today.

St. George Diabetic Eye Disease Retinopathy
St. George Diabetic Eye Disease Retinopathy

Diabetic Retinopathy in All Forms

There are many patients with Diabetes Mellitus who believe that the underlying disease is simply an inability to effectively metabolize and process glucose. Unfortunately, the reality is that the effects of diabetes are considerably more widespread and actually affect many organs and tissue throughout your body. Diabetes causes damage to the small blood vessels throughout the body. When diabetes damages these small blood vessels it can impair the normal circulation of blood in organs and tissues. It is quite common for patients with diabetes to experience difficulty with the circulation in their legs, kidneys, heart, brain and eyes--especially the very small blood vessels of the eye found in the Retina. When diabetes causes damage to the small blood vessels in the retina, it is called Diabetic Retinopathy.

Diabetic Retinopathy is the most frequent cause of new cases of blindness among adults aged 20-70 years old. However, with early diagnosis and treatment, progression of the disease and its associated vision loss can at a minimum be slowed, and in many cases vision loss from Diabetic Retinopathy can be prevented.

Graf Medical Eye Care & Vision Center provides comprehensive diagnostic testing and treatment for Diabetic Retinopathy.

If you, a family member, or a friend, have Diabetes or are glucose intolerant please contact us to schedule a dilated eye examination at Graf Medical Eye Care. We are very conveniently located near the Bluff street/I-15 interchange.

Diabetic Macular Edema

Normally, the small blood vessels in the Retina do not leak. One of the early effects of diabetes is to cause the blood vessels in the Retina to begin to leak by weakening the inner lining of the blood vessels so that they become porous. Leakage from the retinal blood vessels causes the center of the Retina, the Macula, to actually swell, a condition called Diabetic Macular Edema. Diabetic Macular Edema can occur at any stage of Diabetic Retinopathy even with good blood sugar control or even early in the course of the disease.

The Macula is responsible for clearest central vision, and thus Diabetic Macular Edema can result in vision loss of varying severity. The most effective and accurate way to observe and diagnose Diabetic Macular Edema is to perform a careful dilated examination in conjunction with a Cirrus OCT macular scan. We will be able to precisely and directly observe the severity and location of “leaky” blood vessels. It is important that leaking blood vessels be found as early as possible so that they can be most effectively healed using injections of anti-VEGF medication. In most cases, early injection treatment will reduce the swelling and prevent further vision loss, but will not always restore vision that has already been compromised. Early diagnosis and treatment provide the best outcomes for long-term vision.

It is also possible to have Diabetic Macular Edema and not have vision loss. Any diagnosis of Diabetic Macular Edema is an indication that a breakdown of the retinal blood vessels from diabetes is beginning and requires careful monitoring. In the discussions of macular edema, Dr. Graf will also make specific recommendations about how often you will need to return for eye examinations in our St. George, Utah clinic and the need for additional photographs or Cirrus OCT exams. Please be sure to keep these appointments, as they are critical in helping you maintain your eye health and vision.

Diabetic Retinopathy is a common eye disease that affects a large number of patients with Diabetes Mellitus. With early detection and treatment, vision loss from Diabetic Retinopathy can be prevented.

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