Diabetes mellitus, also known as Zuckerkrankheit, is a systemic disease that primarily damages the small blood vessels called capillaries. The retina in the eye is especially vulnerable to this damage. Diabetic retinopathy is the most common and serious eye complication of diabetes. It is the leading cause of blindness among working-age adults in Germany.
The retina acts like the “film” of the eye and consists of millions of light-sensitive cells. Over time, diabetes mellitus damages the smallest blood vessels throughout the body, including those in the retina. This damage is called diabetic retinopathy. Retinal diseases often develop gradually and without noticeable symptoms. If left untreated, they can lead to severe and irreversible vision loss or even blindness.
Regular and thorough examinations are essential to detect these changes early. People with diabetes have a significantly higher risk of becoming blind from retinal diseases.
Chronically elevated blood sugar levels cause two main problems:
First, blood vessels close off. The small blood vessels in the retina become blocked and die, leading to poor blood supply, also known as ischemia.
Second, blood vessels become leaky. Their walls allow fluid and blood fats to escape and accumulate in the tissue.
Diabetic Macular Edema (DME) is the most common cause of vision loss in diabetics. Fluid collects in the center of the retina, the macula, where the sharpest vision occurs. This swelling damages sensitive cells, causing blurry vision and reduced reading ability.
In the late stage, called proliferative retinopathy, the retina responds to oxygen shortage by producing a growth factor called VEGF. This stimulates the growth of new, abnormal blood vessels (neovascularization). These vessels are fragile and can easily cause severe bleeding into the eye’s vitreous. They can also create scar tissue that may pull on the retina and cause dangerous retinal detachment.
Early action is crucial because diabetic retinopathy develops without pain or symptoms at first. Vision problems often appear only in advanced stages.
Watch out for warning signs such as blurry or reduced vision, distorted vision where straight lines look wavy, sudden appearance of black spots or “floaters” due to bleeding, and difficulty seeing in the dark.
The most common and important condition is diabetic retinopathy (DR). It damages the small blood vessels in the retina due to chronically high blood sugar levels.
Type 1 diabetics should have their first eye examination about five years after diagnosis. Type 2 diabetics need to see an eye specialist immediately because the disease often remains unnoticed for a longer time before diagnosis.
Diabetic retinopathy is the leading cause of blindness among working-age adults. However, with regular monitoring and modern treatments like intravitreal injections (IVOM), it can usually be prevented.
A swelling called edema occurs in the macula, the center of sharp vision, due to fluid leaking from damaged blood vessels. This condition is the leading cause of vision loss in people with diabetes.
The macula is the central part of the retina responsible for sharp vision, such as reading and recognizing details. Diabetic macular edema (DME) occurs when fluid leaks from damaged blood vessels, causing swelling in this area. This swelling severely disrupts the function of light-sensitive cells in the macula, leading to distortion and a rapid decline in central visual acuity.
Optical coherence tomography (OCT) is essential because it provides cross-sectional images of the retina. It allows precise measurement of diabetic macular edema down to the millimeter, which is crucial for deciding the appropriate treatment.
VEGF (Vascular Endothelial Growth Factor) is a growth factor that is excessively produced during oxygen deficiency (ischemia). It plays a key role in two harmful processes. First, it increases vascular permeability, which leads to diabetic macular edema (DME). Second, it promotes the growth of new, abnormal blood vessels (neovascularization) during the late proliferative stage of diabetic retinopathy (DR).
Advanced Glycation End products (AGEs) are harmful compounds formed when excess sugar attaches to proteins and lipids. These compounds accumulate in blood vessel walls, making them stiff and damaging pericytes. This damage initiates the development of diabetic retinopathy.
As your eye specialist in Frankfurt, Dr. med. Mareen Schmidt combines extensive clinical experience as a senior physician in the Department of Retinal Diseases with over 10,000 intraocular procedures, including IVOM, laser treatments, cataract surgeries, and vitreous surgery. She uses advanced diagnostic methods at the highest level to ensure precise results. Her approach is based on scientifically proven ophthalmology that focuses on the individual patient. In her practice located in Frankfurt’s Westend, she dedicates time to thorough diagnoses and personal, trust-based consultations.
Dr. med. Mareen Schmidt has been awarded the BDOC seal of quality. This certification is granted by the BDOC as a mark of excellence in eye surgery and is reserved exclusively for experienced eye surgeons.
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