Find A Physician

Return to Preventing and Treating Diabetic Retinopathy Overview

More on Preventing and Treating Diabetic Retinopathy

Newsroom

Return to Preventing and Treating Diabetic Retinopathy Overview

More on Preventing and Treating Diabetic Retinopathy


Research and Clinical Trials

Return to Preventing and Treating Diabetic Retinopathy Overview

More on Preventing and Treating Diabetic Retinopathy

Clinical Services

Return to Preventing and Treating Diabetic Retinopathy Overview

More on Preventing and Treating Diabetic Retinopathy

Preventing and Treating Diabetic Retinopathy

NEW YORK (Jan 13, 2014)

Diabetic retinopathy is a potentially vision-threatening ocular complication which can occur in uncontrolled Type 1 and Type 2 diabetes. In diabetic retinopathy, small capillaries within the eye can leak, which may eventually lead to the growth of abnormal vessels, resulting in vision loss and possibly blindness. Initially, diabetic retinopathy has no, or only minor symptoms. If the disease is poorly controlled for many years then retinopathy typically worsens and symptoms become more pronounced. In the advanced stages, patients become symptomatic and see their ophthalmologist, but by that time treatment becomes more difficult.

Daniel S. Casper, M.D., Ph.D.
Daniel S. Casper, M.D., Ph.D.

"All diabetics should get regular eye checks whether or not they have symptoms," said Daniel Casper, M.D., Ph.D., Director of Ophthalmology at the Naomi Berrie Diabetes Center. Early symptoms may include blurred central vision, darker areas in vision or floaters, but Dr. Casper noted that there are various eye conditions that have similar symptoms and experiencing such visual changes doesn't necessarily indicate the presence of diabetic retinopathy. "In general, if symptoms are related to diabetic changes, the retinopathy is beyond early stages. One of my most important jobs is to educate patients about the need for regular eye exams and maximize the likelihood that they never reach a stage that requires treatment."

The light-sensitive retina (which lines the inside of the eye) has the highest demand for oxygen of any tissue in the body. When oxygen delivery decreases because of capillary damage from diabetes, areas of the retina may become starved for oxygenated blood. Specialized cells within the retina react and attempt to increase oxygenation by producing vascular endothelial growth factors (VEGFs), compounds which produce new blood vessels; unfortunately, this may start a chain of events that usually makes matters worse and leads to further complications.

Diabetic retinopathy can be divided into 2 major groups: the first type is referred to as "non-proliferative," meaning that new blood vessels have not yet formed in the retina, and the second is referred to as "proliferative," indicating that new vessels (referred to as neovascularization) are present. In the non-proliferative form, damage to the capillaries results in bleeding and decreased oxygen delivery to the retina. "There is no treatment per se for the non-proliferative form of diabetic retinopathy, but patients must make every effort to achieve and maintain tight blood sugar, blood pressure and cholesterol control, and stop smoking," emphasized Dr. Casper. Tight control of these three factors and avoidance of tobacco products are the mainstay of prevention," he noted. Progression of retinopathy is usually the result of poor control over a period of years. "Patients are routinely checked with a full ophthalmic evaluation on a yearly basis. If a patient is not in control and diabetic retinopathy develops, they may need evaluation on a more frequent basis," Dr. Casper added.

In proliferative retinopathy, new blood vessels develop in the retina. These abnormal blood vessels can produce fibrovascular scar tissue which covers the retinal surface. Over time, this abnormal tissue may contract, and this results in detachment of the retina from its normal location, which may cause blindness if left untreated. During the early proliferative stage, there is a window of opportunity to treat patients before detachment, and probable vision loss, occurs. The gold standard of treatment since the 1980's is laser treatment. Once a detachment has occurred, surgery is often necessary to repair the damage caused by long-standing proliferative disease.

Ongoing research at NYP and other institutions is currently examining the role of steroids and other new compounds designed to prevent or combat the deleterious effects of VEGF in the eye, thus diminishing the proliferative response. These newer treatments are often performed in conjunction with standard laser procedures.

About the Naomi Berrie Diabetes Center

The Naomi Berrie Diabetes Center, directed by Rudolph Leibel, M.D., and Robin Goland, M.D., combines multi-disciplinary clinical care for patients with diabetes and clinical and basic research programs in diabetes all in one facility. The close geographic proximity of clinicians, scientists, patients, and clinical research subjects facilitates excellent and seamless collaboration and cross-fertilization and provides a unique and vibrant research environment that fosters translational research. The Berrie Center is the only multi-disciplinary diabetes center in New York City.

Post-Note About Dr. Casper

In addition to being an ophthalmologist, Dr. Casper is also an accomplished artist.

  • Bookmark
  • Print

    Find a Doctor

Click the button above or call
1 877 NYP WELL


eNewsletters


Newsroom



Top of page