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What is Diabetic Maculopathy?

Progressing diabetes may lead to a condition known as diabetic maculopathy. Damage to the macula, the area of the eye that serves to give us our central vision, is referred to as maculopathy. When the macula experiences some sort of damage, it is called diabetic maculopathy. Diabetic macular oedema, in which tiny blood vessels or retinal blood vessels close to the macula leak fluid or protein onto the macula, is one such cause of macular degeneration.

Clinically Significant Macular Oedema, or CSMO, is the name used to describe the condition when blood fat exudates from the leaks causing the retina to harden and grow noticeably big and close to the fovea.

Symptoms of diabetic maculopathy

• Trouble with reading.
• Developing vision problems or recognizing faces in the centre of your vision.

Who can get diabetic retinopathy and maculopathy?

Every diabetic has a small chance of developing diabetic retinopathy. This holds regardless of how you manage your diabetes complications through food, medication, or insulin. Diabetic retinopathy is more likely to develop in the following situations:

• You have had diabetes for a long time
• You have persistently high blood sugar levels and your diabetes is poorly controlled
• You have high blood pressure
• You are on insulin treatment or diabetes medication
• You are overweight
• You smoke

How do I prevent diabetic retinopathy and maculopathy?

The following steps can help you lower your chance of developing diabetic retinopathy and maculopathy as well as decrease the progression of the greater risk of diabetic retinopathy, which can deteriorate over time.

• Maintain a balanced, healthy diet; try to limit your intake of salt, fat, and sugar.
• Exercise is the best blood sugar levels management technique. At least once every six months, you should visit your doctor's office to have your average blood sugar level checked. The HbA1c test result should be 48 mmol/mol, or 6.5%, for the majority of diabetics. This figure is crucial for assessing how well you are controlling your diabetes, so you should be aware of it.
• Visit your hospital specialist's office frequently to ensure that your blood pressure and cholesterol levels are within normal range and receive vision treatment if necessary.
• Stop smoking.
• Lose weight
• Exercise regularly e.g. walking.

How is diabetic maculopathy treated?

Although mild macular oedema may go away on its own in certain cases, most people will require laser photocoagulation therapy, which is the first line of treatment for diabetic maculopathy.

Injections of so-called anti-VEGF or anti-vascular endothelial growth factor medications, including Lucentis or Avastin, are among the other treatments.

Managing your diabetes and keeping care of your eyes

Taking proper care of your eyes will help you achieve better results. Maintaining appropriate blood pressure, cholesterol, blood glucose, and an active lifestyle are all necessary for eye care.

Maintaining control of your diabetes is the most crucial aspect of your therapy. Controlling your diabetes can assist in preventing the onset of vision issues in the early stages of diabetic retinopathy, it will help prevent the condition from getting worse in the more advanced stages, when your vision is compromised or at high risk.

It is advised to use a diabetes blood test kit or get it tested from the nearest hospital. Keeping regular check-ups can save you from any other possible diseases.

Advanced diabetic retinopathy and its treatment options

Laser treatment

When diabetic retinopathy has progressed, laser therapy is used to treat new blood vessels or any abnormal blood vessels in the back of the eye. It's carried out because the blood vessels have a tendency to be very weak and frequently bleed into the eyes. Although it hardly improves vision, treatment can help stabilize the abnormalities in your eyes brought on by diabetes and prevent vision loss.

• It includes beaming a laser into your eyes. To numb your eyes, general anaesthesia eye drops will then be utilized, which also enlarge your pupils. Special contact lenses will open your eyelids while the laser focuses on your retina.
• t typically requires 20 to 40 minutes.
• It is typically performed on an outpatient basis, so you won't need to spend the night in the hospital.
• You might need more than one trip to a laser clinic
• It is normally painless, however, you can have a stinging or prickling feeling while specific eye regions are being treated.

Side effects

You can have some adverse effects for a few hours following therapy. These may consist of:

• Blurred vision. You must arrange for a friend or family to drive you home or utilize public transportation until this passes because you cannot drive.
• More sensitive to light. Until your eyes adjust, you might want to use shades.
• Aching or discomfort. Paracetamol or other over-the-counter pain relievers should help.

Possible complications

The dangers of your treatment should be explained to you in advance. Complications that could arise include:

• Impaired night-time or peripheral vision, which could force some people to give up driving.
• Leaking into the eye or floating objects in your field of view.
• For a few months, might be able to see the laser's pattern on the back of your eye.
• A small, persistent blind spot in the middle of your field of view.

If you discover that your vision worsens following therapy, get medical counsel.

Eye injections

Anti-VEGF injections may be administered directly into your eyes in some diabetic maculopathy patients to stop the development of new blood vessels at the rear of the eyes.

• A covering will be placed over the skin surrounding your eyes once it has been cleaned.
• You'll be given little clips to keep your eyes open.
• You'll receive eye drops to numb your eyes.
• The injection is administered with a fine needle carefully inserted into your eyeball.

Initially, the injections are typically administered once a month. It will be discontinued or administered less regularly after your vision begins to stabilize. Sometimes, steroid injections are used in place of anti-VEGF injections or in cases where the anti-VEGF injections are ineffective.

Risks and side effects

Among the potential dangers and negative effects of anti-VEGF injections are:

• Pain or inflammation in the eyes
• Significant bleeding internally in the optic nerve
• Floaters or the sensation that something is in your eye
• Itchy, watery, or dry eyes

Injections run the danger of forming blood clots, which could result in a heart attack or stroke. Even though these risk factors are minimal, they should be discussed with you by your eye doctor before you consent to treatment. Increased pressure inside the eye is the main risk associated with steroid injections.

Eye surgery

Vitreous fluid should be removed from the eyes which is why surgeries are performed. A jelly like-material is then used to fill the space behind the eye's lens. The procedure, also referred to as vitreoretinal surgery, could be required if:

• Your eye has a significant amount of blood accumulation.
• There is a lot of scar tissue that could or has already led to retinal detachment.

To prevent further loss in your vision, the doctor will make a tiny incision in your eye by withdrawing a portion of the vitreous humour, eliminating any scar tissue, and using a laser. Vitreoretinal surgery is typically performed under local anaesthesia and sedation. This implies that will not feel any pain or be aware of the surgery as it is being performed.

On the day of your surgery or the following day, you should be able to return home. You might have to cover your eye with a patch for the first few days. This is because watching television and reading may both quickly weary your eyes.

After the procedure, your vision will likely be hazy. Although it can take a few months for your vision to entirely get back to normal, it should gradually improve. If there are any activities you should avoid while recovering, your surgeon will inform you.

Risks and side effects

Among the potential dangers of vitreoretinal surgery are:

• Getting cataracts
• More eye bleeding occurred.
• Retinal separation
• A build-up of fluid in the cornea which is the outer light-sensitive layer at the front of the eye.
• An eye infection

There is also a remote possibility that you will require more retinal surgery in the future. The hazards will be disclosed to you by your surgeon.

Conclusion

There are 3 stages of Diabetic retinopathy, which are developed over time. The stages consist of background retinopathy, pre-proliferative retinopathy, and proliferative retinopathy respectively. Regular diabetic eye screening appointments for the retina are crucial, screening test involves examining the stage of the disease for diabetic people. While early-stage diabetic retinopathy can be successfully treated with laser photocoagulation, the visual prognosis is poor and vitreoretinal surgery is required for the advanced stages of the disease like proliferative diabetic retinopathy.

Our Diabetes Blood Test home kit can assess your blood glucose levels and confirm if you have diabetes mellitus type 2 or not by the simple finger prick method.

Discuss treatments with your doctor as interdisciplinary care is still crucial despite advances in ophthalmic care for individuals with diabetes, including suture-less pars-plana vitrectomy and intravitreal medicinal therapy. Keeping blood pressure and metabolism under control is essential for lowering the risk of ocular problems.

Find our treatment options for diabetes here, or take an online consultation to find out if there is a suitable treatment for you.