Diabetes & The Body

Diabetic Maculopathy: When It Hits The Bulls Eye

Maculopathy refers to the changes occurring in and around the macula, the central part of the retina. In diabetic patients, small blood vessels in the retina might get blocked and to compensate for the lessened blood supply, the surrounding ones dilate. It has been observed that, usually these dilated vessels are prone to bleeding leading to fluid build up near the macula. This causes swelling or macular oedema, the treatment for which is usually by means of laser.

In diabetic maculopathy, there would be fluid leak from the damaged vessels. These fluids are usually rich in fat and cholesterol. If it so happens that the fluid accumulation is near the center of the retina (the macula) there will be distortion of vision. In extreme cases, it could even lead to permanent loss of central vision.

Maculopathy is known to cause blindness and is found to be more prevalent among people with non-insulin dependent diabetes. Those affected with maculopathy, often report that the vision is blurred as if looking through a layer of muddy water.

Treatment becomes necessary when fluid starts leaking into the macula. The first step is identifying the leaking blood vessels. Next, laser treatment is used to seal the leaking blood vessels. Laser is effective in stabilizing or improving vision in 3/4th of patients having macular edema. Recurring leaks cannot be ruled out completely and studies show that it occurs in 1/4th of patients leading to continued loss of vision even after laser treatment.

Control of the diabetes and blood pressure is important in reducing the chances of leaking vessels returning following treatment. The fluid often takes up to 2 to 3 months to dry up following closure of abnormal vessels. Visual recovery is slow and gradual. If the fluid persists, the fluorescein angiogram is repeated to determine the site of the vessels still leaking and laser treatment may be repeated. The average patients needs 2-3 laser sessions per eye to control diabetic maculopathy over the course of their lifetime

Laser Treatment: Effective?

Typically, lasers operate with bright flashes of light or it could also be an invisible beam. Irrespective of the mode of laser treatment used, patients feel slightly dazzled and often report that their vision is slightly affected for a while shortly after the application of the laser beam. Resting for some time after the treatment is not a bad idea. Those patients who have undergone laser treatments feel that their eyes were more sensitive to the light for quite some time after the treatment. Keeping this in mind it is not a bad idea to have a sunglass at hand, in case of necessity.

Long-term effects of Laser Treatment

Though laser is an effective and advanced form of eye treatment it would be foolish to expect all eye problems to be fixed in a day. Experts say that, it might take upto3 to 4 months before the results of the treatment are noticeable. It sometimes so happens that, a few patients develop macular oedema after laser treatment resulting in a temporary worsening of vision. But it will be back to normal within a few weeks of time. The bottom line is that even if the maculopathy symptoms are not completely rectified, laser treatment can help in preventing it from getting worse.

Repeated sessions of laser treatment may lead to lessened quality of vision, at least temporarily. This effect is due to the fact that laser treatment destroys abnormal vessels in the retina, which might also lead to accidental burning of healthy parts of the retina. Sometimes peripheral field of vision may be affected, which makes driving unsafe, irrespective of how good your central vision is. Patients may also have a tough time seeing in low light, distinguishing colors.