Diabetes, known colloquially as “diabetes,” is a chronic metabolic disease that manifests itself in an increased concentration of sugar in the blood. If left untreated, this leads to sequelae of the blood vessel and nervous system over a long period of time.
In Switzerland, around half a million people are affected.
Diabetes mellitus causes damage to the smallest vessels of organs, including the retina of the eye. At the beginning, there is usually a so-called non-proliferative diabetic retinopathy, which can later lead to proliferative diabetic retinopathy.
Fine retinal blood capillaries can close and then lead to bleeding, leakage of fluid, and lack of oxygen in the surrounding retina.
The undersupplied retina produces a messenger substance (VEGF), which makes the vessels more permeable and causes the formation of new vessels in the retina. This causes diabetic macular edema, which leads to retinal swelling, including in the area of the macula. This results in a significant reduction in vision and can be visualized with a so-called OCT examination (optical coherence tomography).
At the onset of the disease, there are usually no symptoms. Some patients complain of poor vision that can come and go. This can often be caused by the lens of the eye swelling and swelling due to fluctuating blood sugar levels.
Permanent blurred vision due to macular edema or the vision of shadows due to bleeding in the eye may occur later.
Around half of all people who suffer from diabetes develop diabetic retinopathy at some point. Women with known diabetes have a significantly increased risk of diabetic retinopathy during pregnancy.
Annual ophthalmological examinations enable early diagnosis and thus more effective treatment with a better long-term prognosis.
The eyes are examined closely under a microscope, eye pressure is measured and, if necessary, the pupil must be dilated to detect bleeding in the periphery of the retina periphery. Photographic images of the retina are usually taken for documentation purposes.
If diabetic macular edema is suspected, an OCT examination is performed.
If advanced diabetic retinopathy is suspected, fluorescence angiography is performed. This involves injecting fluorescein (a dye) into the vein on the arm. A special camera is used to record how the vessels fill or leak with blood or whether there are retinal areas that do not receive or have reduced blood flow.
The most effective way is to keep blood sugar within a healthy range. This can be achieved through regular exercise, healthy eating and strict compliance with the diabetologist's instructions.
In addition, blood pressure and blood lipid levels are adjusted by the family doctor.
As a rule, no treatment is required when the disease starts; regular ophthalmological checks are important here in order to provide timely treatment if necessary.
