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Worried by my Retinal Screening Result

Discussion in 'Type 2 Diabetes' started by Rachox, May 26, 2018.

  1. Dark Horse

    Dark Horse · Well-Known Member

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    The theory of 'metabolic memory' says that current retinopathy status is based on past, not current, HbA1c values.

    HbA1c 2 to 3 years earlier had the greatest relative risk contribution to current progression of retinopathy. HbA1c up to 5 years earlier made a greater contribution than current values, while values from 8 years earlier still had an important impact. When HbA1c had been at 8% for a long period and was subsequently lowered to 7%, the salutary effects did not begin to appear until 2 to 3 years after lowering.
    https://link.springer.com/article/10.1007/s00125-010-1706-z
    Background retinopathy does not affect your eyesight. Just a single microaneurysm will result in a 'background retinopathy' letter and tends to last a few years before it disappears. Thus, even if no new retinopathy occurs, the person continues to get a 'background retinopathy' result. Retinopathy is likely to improve with continued good glycaemic control.
     
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  2. Energize

    Energize Type 2 · Well-Known Member

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    Interestingly, I've recently had the letter 'background retinopathy'. Last year I was clear but the year before I seem to remember there was something. The first time the letter said I had some 'changes' (can't remember what) I was quite concerned, needless to say. I was then due to see my optician for annual check, told him about this so he had a good look in my eyes, having used dilating drops. He explained he used to do eye screening so was happy to check for me. He couldn't see anything and, as I mentioned, sure enough the next year was clear.

    I was at opticians yesterday, annual check again, and I told him the letter said 'background retinopathy' recently. He did offer to check but, in fact, I suggested that they would have to report 'everything/anything' so, at the moment I wasnt too concerned and would wait until my next scan, in the expectation there is nothing to see again. Hope this is the case, of course ;)
     
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  3. Rachox

    Rachox Type 2 (in remission!) · Moderator
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    Very interesting read, thank you so much for posting the link.
     
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  4. Pipp

    Pipp Type 2 · Expert
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    I recently had my 14th annual retinopathy test since T 2 diagnosis. All clear.. The only scare I ever had was the test after I lost a lot of weight when I was told there were minor changes. As I had also been tested at my optician (who has the same, if not better whizzy machines retina scanning machines) a few weeks before the NHS screening, and told everything was fine, I queried the dodgy test with the NHS folk. They looked at the images again, and said there had been an error. I was fine. Have not had any problem since, with all tests clear. I still get the annual test at optician as well as the NHS screening.
    Hope all the responses have put your mind at ease, @Rachox . You are doing everything else right.
     
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  5. mr_cat

    mr_cat · Well-Known Member

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    Good find.
    That,s been my experience A1c down to good levels but macular oedema increased.
    Frustrating.
    This disease just loves to keep giving and giving.
    So all the best to everyone here.

    Edited by mod
     
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    #25 mr_cat, May 27, 2018 at 7:31 PM
    Last edited by a moderator: May 27, 2018
  6. Ian_Laye

    Ian_Laye Type 2 (in remission!) · Well-Known Member

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    My first retinal scan result was ''Background Retinopathy'' my second result was clear but my vision is getting more blurred which I don't understand.
     
  7. hankjam

    hankjam Type 2 (in remission!) · Well-Known Member

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    I'm not sure if I read somewhere recently that it is a good idea for D's to wear sunglasses when the sun is bright... or is that for the population in general.
    Any thoughts?
    Cheers
     
  8. TonyHancock

    TonyHancock Type 2 · Well-Known Member

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    Today I have just had my first retina scan since diagnosis in October last year. It was all clear.

    I managed to get my meter readings down to the 5-6 range for fasting in November 2017 and have kept them there.
     
  9. DCUKMod

    DCUKMod I reversed my Type 2 · Master
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    Ian - Many, many things can affect our vision and the retinopathy screening we have as diagnosed diabetics should never replace our general sight tests.

    As we age, our eyes can change a bit, meaning we need "a little help with reading", or that we begin to have cataracts form, and I'm sure lots of other reasons.

    If your bloods are running a bit high or low, or simply swinging from high to low, then the vision can be affected, although usually temporarily. If your vision is changing, and you have concerns about it, then you should see and Optician for a decent examination and sight test. As time goes along, comparing sight tests over time can be helpful.

    As diagnosed diabetics our sight tests are free, although there are limitations on how many free tests we can have in any given year or two years (don't ask me the actual number!). However, a normal NHS sight test, for those who normally pay is only around £20, and what price the gift of sight?
     
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  10. DCUKMod

    DCUKMod I reversed my Type 2 · Master
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    Hankjam - I think we should all be using shades in bright sunshine, but particularly those with paler eyes.

    I know whan I have spent a lot of time overseas in the sun, if I don't use shade for any length of time, my eyes can become tired and dry.
     
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  11. Dark Horse

    Dark Horse · Well-Known Member

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    Sunlight can increase the risk of cataracts - people with diabetes are already at greater risk. It also increases the risk of age-related macular degeneration, pterygium, pinguecula, cancer of the conjunctiva and eyelid cancer.

    More info here:- http://www.mydr.com.au/eye-health/eyes-in-the-sun
     
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  12. Jo123

    Jo123 · Well-Known Member

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    @Rachox, try not to worry, I take my elderly mum to all her medical appointments.
    Last year there was slight background retinopathy, just been this year and all perfect!
     
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  13. hankjam

    hankjam Type 2 (in remission!) · Well-Known Member

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    I'm trying to remember to take my sunglasses where ever I go... and then I remembered this:



    :)
     
  14. xfieldok

    xfieldok Type 2 · Well-Known Member

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    @Rachox I am so thankful you posted this thread. I got my retinopathy results today which show some background retinopathy. I would have been quite worried about it had it not been for these wonderful answers.

    In six months I got my HbA1c from 122 to 35. So a drop fairly quickly. I intend to keep on top of things and I am content to wait and see what the next results are next year.

    So thanks to everyone for your helpful replies, you have saved me from becoming a gibbering idiot!
     
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  15. Rachox

    Rachox Type 2 (in remission!) · Moderator
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    This forum is great for stuff like this isn’t it. I went from gibbering idiot to reassured in a few minutes without having to bother my GP or optician who I wouldn’t have got an appt with straight away anyway. Let’s hope we’re both reporting clear tests next time.
     
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  16. hankjam

    hankjam Type 2 (in remission!) · Well-Known Member

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    Had my annual yesterday, so waiting for the mail with the result. Lad suggested all "looked" okay, though the detailed analysis awaits...
    Next thing I have to do is to get to the Podiatrist....
     
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  17. Ann_W

    Ann_W Type 2 · Member

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    Try not to worry too much, I have background retinopathy but it hasn’t changed in 3 years
     
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  18. Mick1952

    Mick1952 Type 2 · Active Member

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    Hi there. I posted a similar concern a month or so ago in reply to a thread about reversing diabetes. My eye test has gone from good to background retinopathy over a 12 month period where my HBa1c was constant at 38! Sorry I can't remember the specifics, but a search should find it, someone pointed me to a link about spiking of BG. I had stopped my regular testing around meals thinking it was not necessary with such good HBa1c, but I started again and found I was regularly spiking after meals. As I recall it, the research papers suggest that short term spiking is more relevant to diabetes complications than average levels I.e. HBa1c results. I'm due another test next month, and have adjusted my diet to stop the spiking ( I think anything over 7.9 2 hours post prandial on a regular basis is likely to lead to retinopathy) Sorry I can't point you to the links, I'm typing from a mobile and struggling to find my post that brought this subject up. Hope you can find it, or someone else can point you in the right direction. Needless to say I was cross with myself for just assuming I was in control based on HBa1c results alone. Diabetes is a complex disease and will trick you at every opportunity if you allow it, so stay one step ahead if you can, and congratulations on your results so far.
     
  19. Rachox

    Rachox Type 2 (in remission!) · Moderator
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    Thanks for your reply. Even a year from diagnosis I test at least 4 times a day, before and 2 hours after breakfast and dinner, my post prandial readings have rarely exceeded 7 since six weeks after diagnosis. I think in my case the explaination is probably historical as suggested by the research posted by @Dark Horse in post #21
     
  20. Grant_Vicat

    Grant_Vicat Don't have diabetes · Well-Known Member

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    To @Rachox @Resurgam @Jaylee @sally and james @Scott-C @Guzzler @Bluetit1802 @DCUKMod @drahawkins_1973 @bulkbiker @hankjam @EllieM @therower @xfieldok @Dark Horse @Energize @Pipp @mr_cat @Ian_Laye @TonyHancock @Jo123 @Mick1952 Here is an excerpt from a letter I wrote to my screening service, adapted for obvious reasons!

    I am however concerned by the statement that according to records I have never been screened by this programme. In fact I have a letter from [Mr A] telling me to attend [my] Surgery DRS at 9.15AM on 28th September 2012. Not only did I attend the screening, but I received another letter from [Mr A] saying he had asked Addenbrooke's to send me an appointment to be checked by a specialist

    I had extensive retinopathy between 1978 and 1983 and for that I had relatively primitive photocoagulation at King's College Hospital. When I went to Addenbrooke's ( [Mr B's ]Diabetic Ophthalmology Clinic) on 31st October 2012, I was seen by one of his team who told me that he thought there were signs of retinopathy. I then waited in a dilated and deeply anxious state for 45minutes. [Mr B] then inspected my eyes and informed his colleague that he was looking at old scarring.

    Bearing your recent letter in mind it occurs to me that although the Diabetic Retinal Screening Service is vital to curb blindness, there is perhaps too much standardisation, especially in correspondence and I would therefore like to suggest that you take me off your list. Obviously if my eyes bleed at any stage, I would of course go to a doctor, as I did back in October 1978.
     
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