Eye Chat – From A Retinal Surgeon’s Perspective
The eye is often described as the “windows to our souls” and in the medical sense, they are indeed the “windows” through which eye doctors can observe a lot of disease processes going on!
The retina is a particularly common place to look when there are other systemic diseases (like diabetes) as there is a wealth of information that can be obtained by looking at the blood vessels in the retina.
What is retinopathy?
Retinopathy refers to a group of conditions whereby the common feature would be dysfunction of the retinal blood vessels. In the case of diabetic retinopathy, the presence of excessive levels of sugar in the blood has an adverse effect on the retinal vessels causing them to be more “leaky’ and consequently, blood and proteins can leak out causing retinal swelling and reduced vision. There is also insufficient oxygenation of tissue and this results in abnormal “growth” of new blood vessels which are prone to bleeding.
Hypertension can also be associated with retinopathy – blood vessels harden with age and progressive narrowing of vessels and reduced oxygenation can lead to bleeding, swelling and strokes in the eye. Other conditions which may be associated with retinopathy include anaemia, leukaemia, lupus and radiation.
Retinopathy and cognitive decline
There has been a recent study which reported a possible link between the presence of retinopathy and worsening cognitive function in older women. This study looked at over 500 healthy older women (over 65 years of age) as part of the Women’s Health Initiative Memory Study and they used retinal photography to assess the eyes of these women, the Mini-Mental State Examination to assess cognitive function over time and also Magnetic Resonance Imaging (MRI) of the brain to look for specific changes.
What they found was that the presence of retinopathy was associated with poorer scores on the mental state test as well as a greater volume of ischemic (oxygen-starved) areas in the brain.
What it means?
The findings of this study add to a growing body of evidence that diseases of blood vessels have a role in the decline of cognitive function in people. Retinopathy may therefore, be an early marker of small vessel disease in the brain and this could imply that screening the eyes for retinopathy could help detect early vessel disease in the brain and cognitive impairment (dementia). Conditions such as Alzheimer’s have far-reaching consequences and if detected early by means of eye screening, could be treated earlier with better outcomes.
But of course these are still early days and further research and studies will be required to evaluate the true relationship between retinopathy and cognitive function. Again another case of “watch this space”. But meanwhile, take care of the “window to your soul”…
For more information about this topic or other eye health subjects, please visit my blog at: www.lec.com.my/youcare-eyecare. Or call Lee Eye Centre: 05-254 0095.