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Difference Between Diabetic Retinopathy and Macular Degeneration

What is Diabetic Retinopathy and Macular Degeneration?

Diabetic retinopathy (DR) and Macular Degeneration (MD) are complications affecting eyes and are a major cause of significant reduction in vision and quality of life.

Diabetic Retinopathy

It is a diabetic disease of eyes that is caused by the damage in the blood vessels in the retina. This disease is treatable but cannot be cured. It may cause no symptoms but only mild problems in vision. The retinal blood vessels are damaged to the extent that it results in leakage of fluid and distorted vision.

Diabetic Retinopathy is of two types:

  • Non-proliferative diabetic retinopathy (NPDR) – Symptomless form of diabetic retinopathy
  • Proliferative diabetic retinopathy (PDR) – Advanced stage of diabetic retinopathy where retinal blood vessels are damaged.

 

Macular Degeneration

Macular Degeneration – an ageing-related eye condition causes progressive macular damage resulting in loss in the centre of the field of vision. Blurred vision is a key symptom. This problem usually develops after the age of 50. Again, treatment can help with the symptoms but there is no cure for this disease available. Key symptom is a slow, painless loss of vision. There are 2 basic types of Macular Degeneration: “dry” (atrophic) type, and “wet” (exudative) type.

 

Difference between Diabetic Retinopathy and Macular Degeneration

Definition

Diabetic Retinopathy

Diabetic retinopathy (DR) is a disease that occurs as a result of damage to the retina blood vessels in people who have diabetes

Macular Degeneration

(AMD) is a degenerative eye disease that gradually damages the macula causing progressive loss of central vision.

Symptoms

Diabetic Retinopathy

  • Poor night vision
  • The impairment of colour vision
  • Patches or streaks that block the person’s vision

Macular Degeneration

  • Extra sensitivity towards glare
  • Inability to see or read in dim and faint light
  • “Fuzzy” or blurred vision
  • Abnormal blood clotting
  • Distorted vision

Lines appear wavy or blurred, with some dark areas at the centre.

Stages

Diabetic Retinopathy

Diabetic retinopathy has a number of stages:

  • Non-proliferative – damage to the blood vessels in the retina, vision is not affected in this stage
  • Proliferative – abnormal and fragile blood vessels begin to grow on the retina.
  • Macular Oedema – the abnormal blood vessels leak fluid into the macula – the centre of the retina – causing blurred vision
  • Vitreous Haemorrhage – the abnormal blood vessel

Macular Degeneration

The course of Age-related Macular Degeneration is different in different people. It has 3 stages:

  • Early-stage Age-related Macular Degeneration: No pigment changes, medium-sized drusen deposits, no loss of vision.
  • Intermediate Age-related Macular Degeneration: Large drusen and/or pigment changes. In this, there may be mild loss of vision, but most of the times, many people do not face any symptoms.
  • Late-stage Age-related Macular Degeneration: Dry or wet macular degeneration (AMD) that causes vision loss.

Complications

Diabetic Retinopathy

  • Vitreous hemorrhage – bleeding in the eyes
  • Retinal detachment
  • Glaucoma
  • Blindness

Macular Degeneration

  • Anxiety or depression
  • Decreased contrast sensitivity
  • Decreased visual acuity
  • Metamorphopsia
  • Central scotoma

Diagnosis

Diabetic Retinopathy

  • Optical coherence tomography (OCT)
  • Fluorescein angiography
  • Dilated eye exam

Doctor can detect the presence of:

  • abnormalities in the blood vessels, optic nerve, or retina
  • cataracts
  • changes in eye pressure or overall vision
  • new blood vessels
  • retinal detachment
  • scar tissue

Macular Degeneration

  • Test for defects in the centre of your vision
  • Fluorescein angiography
  • Indocyanine green angiography
  • Optical coherence tomography
  • Examination of the back of your eye
  • Amsler grid
  • Optical Coherence Tomography (OCT)

Treatment

Diabetic Retinopathy

  1. Early diabetic retinopathy
  2. Advanced diabetic retinopathy

Depending on the specific problems with your retina, options may include:

  • Photocoagulation. 
  • Pan retinal photocoagulation
  • Vitrectomy
  • Injecting medicine into the eye

Macular Degeneration

  • Laser Photocoagulation
  • Anti-VEGF Therapy
  • Anti-angiogenic drugs
  • Laser therapy
  • Photodynamic laser therapy
  • Medications used to treat wet macular degeneration include:
  • Bevacizumab (Avastin),
  • Ranibizumab (Lucentis)
  • Aflibercept (Eylea)

Prevention

Diabetic Retinopathy

  • Strictly controlling alcohol intake
  • Eating a healthy and balanced diet
  • Smoking cessation
  • Regularly exercising
  • Maintaining a healthy body weight
  • Attending regular screenings
  • Taking any antihypertensive measures according to their doctor’s instructions

Macular Degeneration

  • Maintain a healthy weight
  • Eat a nutritious diet that includes green leafy vegetables, yellow and orange fruit, fish and whole grains
  • Wear sunglasses outdoors to block UV and blue light that may cause eye damage
  • If you already have AMD, consult your physician for AREDS (a special combination of vitamins and minerals) formulations, PreserVision AREDS 2 (Bausch + Lomb), such as I-Caps AREDS 2 (Alcon), Eyepex Macula (Eyepex Formulas) or MacularProtect Complete AREDS2 (Science Based Health).
  • Have regular eye exams.
  • Don’t smoke
  • Maintain normal blood pressure and control other medical conditions
  • Exercise regularly

 

Summary

The points of difference between Diabetic Retinopathy and Macular Degeneration

have been summarized as below:

 

Dr. Amita Fotedar -Dr

Research Consultant: PhD in Environmental Sciences at History of working in Elite Research Institutes like United Nations Development Program
Dr Amita Fotedar is an experienced Research Consultant with a demonstrated history of working in elite Research Institutes like United Nations Development Programme, Istanbul, Turkey, Indian Institute of Science, Bangalore, India and International Water Management Institute, Colombo, Srilanka.
Skilled in Biological Sciences, Environmental Health, Natural Resources, Water Resource Management, and Renewable Energy, she has a PhD in Environmental Sciences from the University of Jammu, India. Apart from her PhD, she has a Post Graduate Diploma in International Studies from International Pacific University, New Zealand Campus, and has also been rewarded a certification in Climate Studies from Harvard University (EdX). She is a recipient of Academic Excellence Award from International Pacific University, New Zealand campus. At present she is pursuing MicroMasters in Sustainable Energy from The University of Queensland, Australia.
She is a Co- founder and Research Advisor for a New Zealand based Sustainability and Environmental Services Entity and is also a member of the Environmental Peacebuilding Association at SDG Academy, offering mentorship (a collaborative network of academic and research institutions under the auspices of UN Secretary-General). She has around 35 national and international publications to her credit.
Dr. Amita Fotedar -Dr

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References :


[0]Image credit: https://commons.wikimedia.org/wiki/File:Macular_Degeneration.png

[1]Image credit: https://commons.wikimedia.org/wiki/File:Blausen_0312_DiabeticRetinopathy.png

[2]Bressler, N. M., Bressler, S. B., & Fine, S. L. (1988). Age-related macular degeneration. Survey of ophthalmology, 32(6), 375-413.

[3]Fong, D. S., Aiello, L., Gardner, T. W., King, G. L., Blankenship, G., Cavallerano, J. D., ... & Klein, R. (2004). Retinopathy in diabetes. Diabetes care, 27(suppl 1), s84-s87.

[4]Jager, R. D., Mieler, W. F., & Miller, J. W. (2008). Age-related macular degeneration. New England Journal of Medicine, 358(24), 2606-2617.

[5]Shah, A. R., & Gardner, T. W. (2017). Diabetic retinopathy: research to clinical practice. Clinical diabetes and endocrinology, 3(1), 9.

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