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Retinopathy: Causes, Symptoms & Treatment

Retinopathy is a disease of the retina of the eye. It can seriously impair vision and is often caused by diabetes or high blood pressure.

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Things worth knowing about "Retinopathy"

Retinopathy is a disease of the retina of the eye. It can seriously impair vision and is often caused by diabetes or high blood pressure.

What is Retinopathy?

Retinopathy is an umbrella term for diseases affecting the retina of the eye. The retina is a light-sensitive layer of tissue lining the inner wall of the eyeball, responsible for capturing visual information and transmitting it to the brain. In retinopathy, the small blood vessels of the retina are damaged, which can lead to significant visual impairment or even blindness over time. The condition often progresses without noticeable symptoms for a long period, which is why it is frequently diagnosed at a late stage.

Causes

There are several forms of retinopathy, each with different underlying causes:

Diabetic retinopathy: The most common form. Persistently elevated blood sugar levels in diabetes mellitus damage the blood vessels of the retina. It is one of the leading causes of blindness in adults worldwide.
Hypertensive retinopathy: Long-standing high blood pressure (hypertension) damages the retinal vessels and causes changes in the vessel walls.
Retinopathy of prematurity: Affects premature infants in whom the retinal blood vessels have not yet fully developed.
Other causes: Kidney disease, blood disorders, inflammatory conditions, or medication side effects can also cause retinopathy.

Symptoms

In the early stages, retinopathy often causes no symptoms. As the disease progresses, the following symptoms may appear:

Blurred or distorted vision
Dark spots or shadows in the visual field (sometimes described as floaters or a veil)
Impaired colour perception
Sudden, painless loss of vision
Deterioration of night vision

Diagnosis

Retinopathy is typically diagnosed by an ophthalmologist (eye specialist). The following examination methods are used:

Fundoscopy (ophthalmoscopy): Direct examination of the retina using an ophthalmoscope after dilation of the pupil.
Optical Coherence Tomography (OCT): An imaging technique that provides detailed cross-sectional images of the retinal layers.
Fluorescein angiography: A dye is injected into the bloodstream to visualise blood flow in the retinal vessels.
Visual acuity testing: Measurement of eyesight to assess the degree of impairment.

Treatment

Treatment depends on the underlying cause, severity, and form of retinopathy:

Causal Therapy

The primary focus is on treating the underlying condition. For diabetic retinopathy, optimal blood sugar control is essential. For hypertensive retinopathy, blood pressure must be consistently reduced.

Laser Treatment (Laser Photocoagulation)

Targeted laser beams are used to seal damaged or abnormally formed blood vessels in the retina, preventing further growth and potential bleeding.

Intravitreal Injections

Medications such as anti-VEGF agents (e.g., ranibizumab, bevacizumab) are injected directly into the vitreous of the eye to inhibit the growth of abnormal blood vessels and reduce retinal swelling (macular oedema).

Surgical Treatment (Vitrectomy)

In advanced stages, surgical removal of the vitreous (vitrectomy) may be necessary, particularly in cases of retinal detachment or non-resolving vitreous haemorrhage.

Prevention

Early preventive care and regular check-ups with an ophthalmologist are crucial. People with diabetes should have an eye examination at least once a year. Good control of blood sugar and blood pressure, along with a healthy lifestyle, can significantly reduce the risk of developing retinopathy.

References

World Health Organization (WHO): Blindness and vision impairment - Diabetic retinopathy (2023). Available at: www.who.int
American Academy of Ophthalmology (AAO): Preferred Practice Pattern - Diabetic Retinopathy (2022). Available at: www.aao.org
Cheung N, Mitchell P, Wong TY - Diabetic retinopathy. The Lancet, 376(9735):124-136 (2010). doi:10.1016/S0140-6736(09)62124-3

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