Diabetes mellitus is a chronic metabolic disease indicated by high blood sugar levels and disorders of carbohydrate, lipid, and protein metabolism as a result of insulin function insufficiency. Every year, the number of diabetes mellitus sufferers increases making it one of the priorities in treating Non-Communicable Diseases (NCDs).
Diabetes mellitus sufferers are at risk of experiencing organ damage complications, such as diabetic retinopathy of the eye. Diabetic retinopathy is a long-term complication caused by high blood sugar levels in the nerve lining of the eye. This condition can cause blood vessel leaks, abnormal blood vessel formation, bleeding, and detachment of the retina due to fibrovascular tissue in advanced cases.
Head of the Department of Ophthalmology, Faculty of Medicine, Dr. Cipto Mangunkusumo Hospital, Dr. dr. Ari Djatikusumo, Sp.M(K), said that the condition of diabetic retinopathy in Indonesia is quite worrying. The study conducted by Sasongko, et al. (2017) showed that 1 in 4 adults with diabetes mellitus has vision-threatening diabetic retinopathy. This required follow-up by screening patients with diabetes mellitus, symptoms of diabetes mellitus, and eye symptoms.
“Diabetic retinopathy sufferers usually experience mild symptoms, such as gradual blurring without red eyes or pain. In addition, they can see floating black shadows, either in black spots or hairs and fine lines. More severe symptoms can include loss of part of the visual field or more severe blurring to loss of vision,” said Dr. Ari.
Diabetic retinopathy in diabetes mellitus patients occurs due to leakage of micro and macrovascular blood vessels. In the eye, especially the retina, many microvascular blood vessels are susceptible to leakage and blockage. This is caused by damage due to high blood sugar levels and oxidative stress processes. When there is leakage and blockage of blood vessels in the retina, the optic nerve cannot receive sufficient blood supply, causing damage and loss of vision.
In advanced cases, blocked blood vessels trigger the formation of new blood vessels that are abnormal, brittle, and fragile, causing bleeding in the vitreous body and retina of diabetic retinopathy sufferers. Fibrovascular tissue that pulls on retinal tissue can also develop, causing retinal detachment or detachment of the optic nerve. The formation of blood vessels in the exit of eye fluid can also increase eye pressure and cause excruciating pain.
According to Dr. Ari, the best treatment for this case is prevention. Diabetes mellitus sufferers should undergo regular screening. Blood sugar levels must be maintained within normal limits and have routine checks by a specialist in internal medicine. For patients who have been diagnosed with diabetic retinopathy, they must undergo follow-up, laser, injection, or even surgery, depending on the severity.
Moreover, there should be information spread from academics and health workers about this disease. Cadres and community health centers must actively socialize and screen the possibility of people suffering from diabetes mellitus. We need to do a routine screening, so the sufferers are immediately detected. “For colleagues who experience symptoms of this disease, please immediately check with the nearest ophthalmologist,” said Dr. Ari.
Dr. Ari has done a health education regarding diabetes mellitus and diabetic retinopathy in community service activities held by the Department of Ophthalmology, Faculty of Medicine UI in 2023, at Sawangan District Office, Depok. After the counseling session, the Service Team did diabetic retinopathy screening for 100 participants suffering from diabetes mellitus. The screening included checking visual acuity, intraocular pressure, the anterior segment of the eye, and the posterior segment (retina) of the eye. Participants were also given recommendations regarding eye examination results.
