Protect from Diabetic Retinopathy (diabetic blindness)

Diabetic retinopathy refers to the retinal changes in patients with diabetes mellitus. It is a common complication of diabetes mellitus, which can eventually lead to blindness. It is an ocular manifestation (involves the eye) of systemic disease which affects up to 80% of all patients who have had diabetes for 10 years or more. With the increase in life expectancy of people with diabetes, the incidence of retinopathy is on the rise. It is the leading cause of blindness in the developed nations. Research indicates that at least 90% of these new cases of diabetic retinonathy could be reduced if there was proper and vigilant treatment and monitoring of the eyes.

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Methods to prevent progression of Diabetic retinopathy
1) Regular eye check ups. Consult your diabetologist for further advice.
Recommendations vary depend on the degree of progression.
2) Recent studies suggest that even a peripheral doctor or a trained paramedic is helpful in recognizing these changes.

This study was lead by Dr. Hugh Taylor at the University of Melbourne in Australia. The objective was to investigate whether remote clinics could help reach people who would otherwise not visit an eye specialist, Taylor and his team reviewed data from 20 studies that compared the accuracy of eye exams using these clinics to what a specialist would do. They found that, overall, remote screening picked up 83 percent of people with retinopathy, which Taylor called "very good," and it didn't matter whether or not the photographer had medical training or not. However, the screens falsely labeled 12 percent as having retinopathy even though they didn't, and photographers with less training were more prone to such mistakes.

Another study done in this aspect towards the prevention of diabetes is to know the factors that may aid in delaying the progress of the disease. the following are the results of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Eye Study, supported by the National Institutes of health.  The ACCORD Eye Study clearly indicates that -
3)intensive glycemic control and 
4) fibrate treatment added to statin therapy separately reduce the progression of diabetic retinopathy. "The main ACCORD findings showed that fibrate treatment added to statin therapy is safe for patients like those involved in the study. However, intensive blood sugar control to near normal glucose levels increased the risk of death and severe low blood sugar, so patients and their doctors must take these potential risks into account when implementing a diabetes treatment plan."In high-risk adults with type 2 diabetes, researchers have found that two therapies may slow the progression of diabetic retinopathy. 

Intensive treatments included control of blood sugar to near normal levels, control of blood pressure to normal levels, and combination treatment of multiple blood lipids with fenofibrate and simvastatin compared to standard treatment with simvastatin alone. Fenofibrate treatment lowers triglycerides and raises the "good" high density lipoprotein (HDL) cholesterol levels, while simvastatin lowers the "bad" low density lipoprotein (LDL) cholesterol levels.

Intensive blood sugar control reduced the progression of diabetic retinopathy compared with standard blood sugar control, and combination lipid therapy with a fibrate and statin also reduced disease progression compared with statin therapy alone. However, intensive blood pressure control provided no additional benefit to patients compared with standard blood pressure control.

Compared with standard blood sugar control, intensive control decreased the progression of diabetic retinopathy by about one-third, from 10.4 percent to 7.3 percent, over four years. Participants in the intensive control group had a median blood sugar level of 6.4 percent hemoglobin A1c-a level close to values in people without diabetes. The standard blood sugar control group maintained a median level of 7.5 percent.

In addition, compared with simvastatin treatment alone, combination lipid therapy with fenofibrate plus simvastatin also reduced disease progression by about one-third, from 10.2 percent to 6.5 percent, over four years. No prior clinical trial has shown that the combination of fenofibrate and simvastatin reduces diabetic eye disease progression.

Treatment options include laser photo coagulation, panretinal photocoagulation, intra vitreal triamcinolone, and finally vitrectomy.