Retinopathy question

I don't believe any retinopathy can be reversed which is why it's so important for diabetics to control blood sugar to avoid damage to the capillaries in the retina.

Retinopathy means damage/death of the retina. I believe that some damage my be caused without the loss of vision (yet) but I don't think it can be reversed. I just read up on what Mayoclinic says on the subject.

http://www.mayoclinic.org/diseases-conditions/diabetic-retinopathy/basics/definition/con-20023311

Vision loss unfortunately can't be reversed but diabetic retinopathy can be halted with good bg, bp and cholesterol control, but like most things there's no guarantees.

As you've not been told you have retinopathy you need to attend all your appointments and work with HCP's on reducing your overall bg levels, if any changes in your eyes are noticed they will write to you and your diabetes team to let them know, so try not to worry.

However, if you want to read about diabetic retinopathy then have a look at the following:

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

Hi, I don't know about the timescale but blood sugar is the most important point rather then blood pressure

larennaise said:

Thanks for your help. Out of interest, it's been 13 months since my last eye test. Can retinopathy develop during that relatively short space of time? I've heard it develops slowly. I generally have low blood pressure.

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None of us are qualified to say, but usually retinopathy comes on slowly starting with what they call Background Retinopathy, this is where the first signs of changes in your eyes appear.

Have a good read around the site I posted earlier, it has a wealth of information on diabetic retinopathy and how you can prevent it, but the best thing you can do to help prevent it happening is controlling your bg levels.

Try not to stress about it too much as you haven't been told yet that you have retinopathy, good luck on your next screening anyway.

Hyperglycaemia results in increased oxygen consumption and decreased oxygen tension in tissues such as the retina. As oxygen is essential for retinal function, there is convincing evidence that oxidative stress (the overproduction of reactive oxygen species (ROS)) triggered by the body as a natural response to hyperglycaemia causes retinopathy. In addition to oxidative stress, hyperglycaemia induces several changes including leucostasis, vasoconstriction and a pro-inflammatory state that also causes hypoxia in the retina.The earliest retinal pathology and the earliest biochemical changes include alterations to the appearance of microglia, the formation of Advanced Glycation Endproducts (AGEs), the overproduction of Vascular Endothelial Growth Factor (VEGF) and its mRNA, and consequent leakage of capillary endothelial cells. These early pro-inflammatory changes can directly cause hypoxia in the retina and not necessarily via ROS [Arden GB and Silvaprasad S, Hypoxia and oxidative stress in the causation of diabetic retinopathy, Curr Diabetes Rev. 2011 Sep; 7(5): 291-304].

Two important things can be understood from above: 1) avoiding hyperglycaemia, as already mentioned, is vital to halt the progress of retinopathy; 2) the retinal response is very subjective as well as the development and progress of retinopathy. Despite that, a number of methods of treatment of diabetic retinopathy depend upon the relief of retinal hypoxia. This is not the case of laser, which is indeed not a treatment in the sense that it doesn’t remove the cause of retinopathy, but it is the case of the active ingredients in eye injections such as Lucentis by Genentech (http://www.lucentis.com) or of the innovative non-invasive Noctura 400 treatment by PolyPhotonix (http://noctura.com/index.php). I’m using this last not-scary alternative, which is a mask worn at night to deliver a precise dose of light therapy during normal hours of sleep.The mask prevents dark adaption hence hypoxia in the retina as explained by the company manufacturer: http://noctura.com/healthcare.php. I’m using it for prevention purposes as I do believe that if the cause of retinal stress is removed (and I’m not talking here about hyperglycaemia but rather about the effects of hyperglycaemia on the retina), then the retina should be gradually able to heal itself from damages already in place.