Figures have revealed that 17.3 per cent of the UAE population between the ages of 20 and 79 have been diagnosed with type 2 diabetes. People with diabetes are known to be more at risk of developing eye conditions, such as cataracts, glaucoma, or retinal vessel occlusion. Diabetic retinopathy and Diabetic Macular Edema (DME) are two of the top five eye problems affecting UAE patients, so there is a huge need to raise awareness of the serious consequences.
Arab Health Magazine spoke to Dr. Saleh Saif Al Messabi, Head of the Emirates Ophthalmology Society, about the impact of diabetic eye disease on the UAE society.
What are the most common diabetic eye diseases in the UAE and what are the prevalence rates?
Diabetic retinopathy is the leading cause of blindness among working-aged adults and is the most common diabetic eye disease. It is a leading cause of irreversible blindness in adults in the UAE. It usually affects both eyes and is caused by ongoing damage to the small blood vessels of the retina.
Poor glucose control and hypoxia cause new weak blood vessels to grow and leak fluid into the retina. Abnormal blood vessels also grow on the surface of the retina, which can bleed and block vision. The progression of Retinopathy is gradual, advancing from mild to advanced. One study found prevalence of retinopathy to be 19 per cent in the UAE and was more likely to occur in older males.
DME in particular is caused by a complication of diabetic retinopathy. The leakage of fluid into the retina may lead to swelling of the surrounding tissue, including the macula. DME is the most common cause of vision loss in people with diabetic retinopathy. Poor blood sugar control and additional medical conditions, such as high blood pressure, increase the risk of blindness for people with DME. It can occur at any stage of Diabetic Retinopathy, although it is more likely to occur later as the disease goes on.
What are the symptoms and how is it detected?
Primary symptoms of Diabetic Retinopathy and DME include spots in vision, blurred or fluctuating vision, impaired colour vision, dark of empty areas in vision or vision loss. If only one eye is affected, patients may not notice vision is blurry until the condition is well advanced.
The condition is diagnosed through various eye exams looking for abnormalities in the retina, including dilated eye exams where drops are placed on the eye to dilate the pupil. A fluorescein angiogram or optical coherence tomography may also be carried out to conform diagnosis.
How can people with diabetes protect their vision?
Early detection is imperative for positive outcomes with Diabetic Retinopathy, hence a broad range of primary care facilities offer screening programmes for DME across the UAE. Patients are urged to have their eyes examined as soon as they are diagnosed with diabetes (particularly type 2), as in some cases Diabetic Retinopathy has already manifested.
The key to preserving eye health and reducing the risk of diabetes complications is to tightly regulate your blood sugar as high blood sugar can damage the tiny blood vessels in the retina. It’s also important to manage blood pressure, as this can also affect eye health.
One study found prevalence of retinopathy to be 19 per cent in the UAE and was more likely to occur in older males.
Are there any new therapies to treat diabetic eye disease?
There are many treatment options and therapies to help diabetic patients diagnosed with Diabetic Retinopathy and DME including laser treatment, invasive intraocular injections into the eye, or steroid implants. Many potential new therapies for Diabetic Retinopathy with new targets are currently being studied in clinical trials and look promising. These include various inhibitors that suppress the detrimental effects of hyperglycaemia on the retina. Preventative approaches such as phototherapy, advanced glycation end product blockers and antioxidants are also being trialled. Also, being studied are surgical and technological approaches for vision restoration.
References
Al-Maskari F, El-Sadig M. Prevalence of diabetic retinopathy in the United Arab Emirates: a cross-sectional survey. BMC Ophthalmol. 2007;7:11. Published 2007 Jun 16. doi:10.1186/1471-2415-7-11