Photo Mapping in Diabetic Retinopathy

January 18, 2018 Jeanette Stern

Fundus Photography is a type of photo mapping that is done to track progression of changes in the back of the eye for people who have been diagnosed with diabetic retinopathy. The changes in the eye over time are critical, as treatment approaches are designed for diagnostic stages of retinopathy. Fundus photography is part of a detailed eye exam, and is covered by most insurance when diabetic retinopathy is diagnosed secondary to Type I or II diabetes. 

Eyes and visual health are at significant risk for people suffering with diabetes. Diabetes is the leading cause of blindness for people between 20 and 74 in America, and people with diabetes are 25 times more likely than non-diabetics to develop blindness in their lifetime. Diabetic retinopathy is eye damage specific to diabetes, and is related to how long the disease has been present and the degree of glycemic, or blood sugar control. People with diabetes are also at increased risk of glaucoma and cataracts. A detailed eye exam for a person with diabetes is a specialized eye exam that can grade retinopathy, if it is diagnosed. This grading determines treatments. Standards of care for people with diabetes include a detailed eye exam for diabetic retinopathy at the time of diagnosis and at least yearly after. When diabetic retinopathy is diagnosed, the frequency of exams increases. 

Diabetes impacts the tiny blood vessels in the eyes, kidneys, and nervous system as one of the earliest significant impacts on health. The tiny vessels, many with walls as thin as one cell wide, cannot handle the heavy and acidic sugar molecules. The vessels respond by developing aneurysms and then hemorrhages. After the early changes in the blood vessels, areas of poor blood flow develop, then swelling, and the retina, the vision and light collecting tissue in the back of the eye, begins to fail. These changes can happen over many years, and with good diagnosis and tracking, as well as good blood sugar control, the progression of the retinopathy, ending in loss of vision, can be stopped or slowed considerably. 

The changes in the blood vessels of the eyes usually happen along a standard progression, and this progression is what the photo mapping is designed to document. The fundus photography takes an image of the retina of the eye in all four quadrants, and each subsequent photo is compared for changes to the size and shape of the blood vessels, any evidence of bleeding, cotton wool patches, which are signs of ischemia, or lack of blood flow, swelling, damage to the macula or detachment of the retina, and other, more serious damage. 

The photos allow ophthalmologists to make detailed and early diagnosis, and to grade the retinopathy. This can lead to greater glycemic control, by referral back to diabetes specialists, as well as beginning treatments for specific, graded diagnosis of retinopathy. 

In addition to efforts to improve diabetes side effects through better glycemic control, specific treatments for retinopathy include targeted treatments for the blood vessels, to reduce aneurysms and bleeding, and efforts to reduce swelling and retinal damage. There are both laser treatments and medications that can impact these areas. 

The critical piece in keeping the vision intact for people diagnosed with diabetes is regular detailed eye exams by an ophthalmologist who has a practice of diabetic patients. This familiarity with the tools and treatments used with diabetic retinopathy ensures the most up-to-date practice. Many specialists now use photo mapping with fundus photography to ensure that the progression of diabetic retinopathy is slowed or stopped with good glycemic control and proper diagnosis, grading, and treatment. 

For more information on diabetic retinopathy or photo mapping, please contact us.

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