The main cause of preventable visual loss in the country, diabetic retinopathy can progress without symptoms for years
Diabetic retinopathy is one of the most common complications of diabetes and, at the same time, one of the least noticed by patients. It is a disease that affects the blood vessels of the retina, region at the back of the eye responsible for image formation. Today, it is considered the main cause of preventable blindness in Brazil, mainly among adults of working age.
The big challenge is that the retinopathy can evolve silently for years, without pain or obvious loss of vision, which means that many people only discover the problem in advanced stages.
Excess glucose in the blood progressively damages the retinal vesselsmaking them fragile, permeable and prone to leaks. Over time, this compromises tissue oxygenation and triggers a series of changes, such as hemorrhages, macular edema and the formation of abnormal vessels that can bleed and lead to visual loss. That process is faster and more aggressive when diabetes is poorly controlled, there is associated high blood pressure or the patient has lived with the disease for many years. Therefore, regular follow-up with an ophthalmologist is as important as glycemic control.
Warning signs
Diabetic retinopathy is dangerous mainly because it is silent. In the initial stages, the patient sees normally, even if the retina is already compromised. This creates a false sense of security and postpones seeking medical evaluation.
However, there are symptoms that serve as a warning: blurred vision, dark spots that float in the field of vision, difficulty reading, image distortions and sudden loss of vision. When these signs appear, the damage is usually significant and consultation becomes urgent.
The fundamental exam for diagnosis is retinal mapping, simple, quick and completely painless. Optical coherence tomography (OCT) and fluorescein angiography can complement the investigation in more advanced cases. The goal is to identify changes before they cause permanent visual loss, as treatment is more effective when started early. For patients with type 1 and type 2 diabetes, the recommendation is to undergo an annual ophthalmological evaluation – or more frequently if changes have already been detected.
Modern treatments
The treatment of diabetic retinopathy has evolved significantly in recent years. In the most severe forms of the disease, especially when there is macular edema or proliferation of abnormal vessels, the use of anti-VEGF medications applied directly to the eye is currently the most effective therapy. These medications reduce swelling, control the formation of new vessels and help stabilize the condition. In some cases, laser or vitreoretinal surgery may be necessary to control bleeding and more advanced complications.
Despite available treatments, diabetes control remains the most decisive factor to preserve vision. Maintaining stable blood glucose, controlling blood pressure and taking care of your diet reduce the risk of disease progression and improve the response to therapies. Regular physical activity, multidisciplinary monitoring and smoking cessation are also part of prevention.
Diabetic retinopathy is preventable in most cases, as long as it is diagnosed early. Information, regular consultation and attention to the first signs are the main tools to prevent diabetes from compromising your vision. Even those who see perfectly should have an annual exam, as healthy vision today does not guarantee that the retina will be protected tomorrow.
Dr. Tayuane Ferreira Pinto – CRM/PR 37,321 Eqr 27,741
Ophthalmologist
Membro da Brazil Health
