3 May 2011

KUALA LUMPUR: One in four patients with severe diabetic-related retina damage end up blind because they come in too late.

The national Diabetic Eye Registry principal investigator Dr Nor Fariza Ngah said that out of 13,973 patients with diabetic retinopathy, 3,311 suffered severe retinal damage and of them, 774 could no longer get their blindness reversed.

The statistics were derived from 36,952 diabetic patients screened for diabetic retinopathy from January 2007 to December 2009.

Dr Nor Fariza told The Star that the symptoms were often missed because it was asymptomatic, with some seeing floaters or having blurred vision.

For this reason, she said all diabetic patients must get their eyes examined at least once a year.

Retinal damage occurs when the thin layer of the retina is detached from the eye-wall and patients could suffer bleeding in the eye-ball as well. Blockage in the eyes’ blood vessels results in new blood vessels growing into the eye cavity to compensate the blockage and pull the retina away from the back wall of the eye.

It also occurs when protein leaks from the vessel into the surrounding retina and causes swelling.

Universiti Malaya Medical Centre retinal surgeon Dr Angela Loo said some patients ended up blind despite a well-done surgery because they came in too late.

“Often, they expect us to perform miracles, but even if we managed to do a good job re-attaching the retina, their sight cannot be restored.”

Dr Loo, who trained in Britain for seven years and practised in Hong Kong for four, said severe retina damage numbers were low in both countries.

She said the lack of awareness and complacency among Malaysians, were the main reasons for many diabetes cases being undiagnosed and poorly controlled, adding that some patients also did not return for follow-up laser treatment and their condition deteriorated.

She said teamwork was needed in detecting the symptoms, adding that the high-risk groups included those with diabetes for a long time, poorly controlled blood sugar and blood pressure, presence of other diabetic complications such as kidney impairment and foot ulcer/gangrene, high blood cholesterol, smoking habit, anaemia and diabetes in pregnancy.

This article was published in www.thestar.com.my on 10 March 2010.