November 17, 2019
How Does Diabetes Affect the Eyes – David Boyer MD

How Does Diabetes Affect the Eyes – David Boyer MD


Approximately 20 million in the U.S. have
diabetes and one third of those are unaware they have the disease. We went to Good Samaritan
Hospital in Los Angeles and spoke with Dr. David Boyer, we ask him how diabetes affects
the eyes. Well for the most part diabetes is one of
the leading causes of blindness. It affects the eyes in many ways. One of the most common
way is with causing changes in the retina. There are two forms of changes. One is called
nonproliferative diabetic retinopathy and the other is called proliferative diabetic
retinopathy. Non proliferative diabetic retinopathy means that the blood vessels that we’re born
with, that nourish the retina, begin to leak fluid, they begin to leak serum and blood
products and this causes swelling of the retina. The swelling of the retina actually can diminish
the vision. Proliferative retinopathy implies that you are developing abnormal blood vessels
and this is usually in response to a poor blood supply that diabetes causes. The most
of the visual loss is secondary to what we call diabetic macular edema which is a leakage
of serum, blood products, lipids into the center foveal area that has to do with your
ability to read, watch television and to see peoples faces clearly. Diabetes forms scar
tissue and these abnormal blood vessels that are forming are very fragile and they can
pull and they can actually pull the retina off and in that case you have to do a surgery
to relieve all the traction to try to take the blood vessels off the surface of the retina
and to cauterize it and reattach the retina so the patient can see. Nonproliferative retinopathy
for the most part is a non surgical disease except for laser and injections. How important
is getting your diabetes under control? If you don’t get your diabetes under control
the systemic factors, the blood sugar, the blood pressure and the lipids, you’re going
to have continued damage not only to your eyes but to the rest of your body, to your
kidneys, and to the nerves that supply the sensory input to your legs so you’ll end up
with neuropathy, kidney problems and other changes that can occur. It’s been shown in
numerous studies that if you can get your blood sugar under excellent control for long
periods of time up to 26 months, then you can actually get a reversal of a lot of the
diabetic changes. So it’s not inevitable that it will continue to worsen. Blood pressure
is also very important and control of your lipids and so it is extremely important that
you continue with your internist or your diabetologist or endocrinologist who’s going to be taking
care of your diabetes to get your A1C Hemoglobin or a measure of average blood sugar over a
3 month period into as low a range as you can safely and by doing this over a long period
of time you can actually improve your retinopathy. Dr. Boyer tells us about the new advances
for diabetes. Well actually in the last several months there’s been a major breakthrough in
our treatment of diabetic retinopathy. Clinical trials and a stage 3 were able to show a marked
improvement in the vision in patients that received ranibizumab treatment or Lucentis
is the trade name, every month for over a 3 year period and they were actually get an
improvement to 36 to 40 percent of the patients actually getting 3 lines of improvement which
is much much higher than we every have with laser, which was in the range of 3 to 15 percent,
3 line gainers. So this is really a new paradigm for ophthalmologists and for patients. We
are able to treat patients without causing any damage to the central area, cause laser
is destructive even though it does work it is somewhat destructive. So we are limited
how close we can get to the center when we treat with this we’re able to treat and if
we can treat aggressivelly, we’ll be able to save a lot more patients from going blind.

4 thoughts on “How Does Diabetes Affect the Eyes – David Boyer MD

  1. My mom is having diabetes for more than 25 years.. Her eyes are worsening day by day.. one of her eye is shortening day by day… can u suggest something?

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