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This common complication of diabetes is the leading cause of vision loss among working-age Americans. Especially likely when diabetes is poorly controlled, diabetic retinopathy can occur as background or nonproliferative retinopathy or as proliferative retinopathy.
Background or nonproliferative retinopathy can cause swelling of the retina (macular edema) and mild to moderate blurring of vision. Dietary or insulin treatment does not necessarily stop progression. With time, the retinal disease can progress to the proliferative form.
In proliferative retinopathy, tiny blood vessels grow into the vitreous - the jellylike fluid that fills the interior of the eyeball behind the lens. If these vessels break and bleed into the vitreous, severe vision loss may result.
To diagnose diabetic retinopathy, Wilmer professionals often use a special technique called fluorescein angiography. A medical dye injected into the arm travels to the eye. A special camera photographs the retina as the dye passes through it. The dye makes it easy for the physician to observe changes in the retina. The test also is used as a guide for treatment or to help determine the cause of vision loss.
Wilmer has invested substantial time and effort in fighting diabetic retinopathy, beginning in the late 1960s with pioneering work in new techniques to diagnose and combat abnormal blood vessels. Wilmer researchers also were pioneers in the development of the argon laser for treating retinopathy. Laser light slows or stops abnormal growth of blood vessels in the retina, decreasing the loss of sight. Wilmer ophthalmologists also helped perfect an operation called vitrectomy, in which the vitreous is removed so that retinal damage may be minimized or even reversed. Afterward, the vitreous space is filled with a replacement fluid. Patients at Wilmer also are seen by specialists from The Johns Hopkins Diabetes Center, who can help control the disease through tighter maintenance of blood-sugar levels.
> Treated by the Retina Division