Maculopathy & low carb

[helen louise]

Hi All
I had to go off my low carb plan for a few months last year (long story) but have been back on the plan for 6 weeks, I had my eye screening last week & received a letter on Friday advising me that I am being referred to the hospital for further checks as my eyes are showing signs of maculopathy, now from my extensive googling sessions over the weekend it appears that this can happen if your blood sugars have started to drop suddenly, this is obviously the case with me but will the hospital take any notice regarding this info? the last thing I want is injections in the eyes if this will clear up in a short time, I am worrying myself sick here about it

Just to add I have no issues with my eyes in terms of blurriness

 

[novorapidboi26]

I too have maculopathy in one eye and attend the ophthalmology clinic every 6 months as opposed to a photo centre annually.....

you wont be getting injections necessarily....

maculopathy is simply retinopathy at the macula, the centre of the back of the eye.....so its a but more serious but cant still be minor in nature if you know what i mean....and as far I know can clear up and get better, maybe not go completely but better definitely....

when you ask about the hospital not taking notice are you referring to your diabetes team?

 

[helen louise]

Thank you, no I was just wondering if when I go to the referral appointment at the hospital if they would take into account the recent introduction of the low carb diet or if they would just discount it & book treatment etc

 

[Alison Campbell]

@helen louise, do you self test your glucose levels? It might be helpful to show them if your condition happened during a drop in levels.

 

[helen louise]

Yes I do, prior to low carb I was running between 16-20 mmol (sometimes higher)
this last week I have dropped to between 10-16mmol, its not dropping dramatically as I have only been decreasing the carbs slowly as I am on a couple of types of meds (gliclazide/dapagflozin) I didn't want to go through the carb flu thing or false hypos as I am currently learning to drive so cutting down slowly

 

[Alison Campbell]

That is the evidence you need and sounds like a good plan

 

[novorapidboi26]

Thank you, no I was just wondering if when I go to the referral appointment at the hospital if they would take into account the recent introduction of the low carb diet or if they would just discount it & book treatment etc

To put it simply, any treatment you need for your eyes wont be influenced by what your diet is or has been.....all they are concerned with is treating any issues that are present NOW....

Do you know the extent of the maculopathy.....

 

[helen louise]

No, only received the letter of Friday, the letter just said that the test showed signs of diabetic maculopathy & that it needed to be checked further, now waiting for an appointment for the hospital

 

[novorapidboi26]

My maculopathy is described as referable diabetic maculopathy, which basically means bleeding on the macula.....

so the same as retinopathy, just closer to the middle.......

I go every 6 months to the clinic where a visual acuity test is carried out, pressure tests on my eye balls and then eye drops for pupil dilation, photographs [as normal] and finally an examination from the consultant with their on manual device.....

So far there has been no notable deterioration and so I come back in 6 months....

So this is the minimum you can expect....

hopefully you are the same as me but there may be more issues that need further treatment but you will be fine....

 

[Brunneria]

I would agree with @novorapidboi26

If your eyes need treatment, then they need treatment, regardless of the cause.
From my understanding of lc and retinopathy, rapid hba1c drops may worsten pre-existing retinopathy, but it won't cause it in a patient who doesnt already have the condition beforehand, even though the condition may have been undiagnosed or mild.

Well done for getting back in control. Whatever the short term consequences, it is an investment in your future, and will help to prevent or delay other long term cmplications.

 

[noblehead]

Thank you, no I was just wondering if when I go to the referral appointment at the hospital if they would take into account the recent introduction of the low carb diet or if they would just discount it & book treatment etc

No they won't be interested in your diet, the only time that diet has been discussed when I've attended the Ophthalmology Clinic is when I've brought the subject up myself, I only asked as I wanted to know which fruit & veg were beneficial to eye health, the answer was all but the darker the fruit/veg the better apparently.

Moorfields Eye Hospital has a brief but good explanation on the two type of diabetic retinopathy:

Many people with mild diabetic retinopathy have good vision, but there are two types of sight-threatening diabetic retinopathy: diabetic macular oedema (DMO) and proliferative diabetic retinopathy (PDR).

In DMO, fluid leaks out of the tiny damaged blood vessels in the back of the eye, and accumulates in the macula, the central part of the retina which is responsible for seeing fine details and central vision. This leads to swelling of the tissue and blurred vision. Eventually, patients with diabetic macular oedema can develop poor central vision and be unable to read or drive, but the vision to the side usually remains normal.

Proliferative diabetic retinopathy is when the retinal blood vessels close resulting in the retina being starved of blood. This causes abnormal and very fragile blood vessels to grow on the surface of the retina which can lead to permanent loss of vision from bleeding into the eye, retinal scarring and retinal detachment.

http://www.moorfields.nhs.uk/condition/diabetic-retinopathy

now from my extensive googling sessions over the weekend it appears that this can happen if your blood sugars have started to drop suddenly, this is obviously the case with me but will the hospital take any notice regarding this info?

I'm sure this is only the case if you already been diagnosed with DMO, but the Ophthalmologist will give you a definite answer when you attend the clinic. Just have a good read through the following website which has a wealth of information and advice on DMO:

http://www.diabeticretinopathy.org.uk/diabetic_maculopathy.html

Good luck and keep us updated on your progress.

 

[Dark Horse]

The maculopathy detected at eye screening may or may not need treatment.

Further tests by the hospital may show:-

• no swelling (oedema) at the macula - you would not need treatment and would be returned to screening
• mild swelling at the macula - you would probably be monitored every few months to check if it is progressing
• clinically significant macular oedema (CSMO) - you may be offered treatment such as injections into the eye or mild laser

Ophthalmologists are not keen to give treatment unless it is really necessary. If they are considering whether to offer you treatment, it would be worth telling them about your sudden improvement in control so they can take that into account.

Just to add: the most effective time for treatment is before symptoms such as blurriness occur. That is why it is important to attend diabetes eye screening regularly and not just rely on symptoms. Obviously, any sight changes between screenings should be investigated promptly.