Diabetic Retinopathy

What Is Diabetic Retinopathy?

Diabetic retinopathy is one of the most common causes of vision loss in working-age adults. It occurs when elevated blood sugar levels damage the small blood vessels that supply the retina — the light-sensitive tissue at the back of the eye. Over time, these damaged vessels can leak fluid, bleed, or stimulate the growth of abnormal new blood vessels, each of which can impair vision.

Types and Stages

Diabetic retinopathy is broadly classified into two stages:

• Non-proliferative diabetic retinopathy (NPDR): Early to moderate disease, where blood vessels weaken and may leak fluid or blood into the retina. Diabetic macular edema (swelling of the central retina) can occur at this stage.
• Proliferative diabetic retinopathy (PDR): More advanced disease in which abnormal new blood vessels grow on the surface of the retina or into the vitreous. These vessels are fragile and prone to bleeding, and can lead to tractional retinal detachment.

Symptoms

In the early stages, diabetic retinopathy may cause no noticeable symptoms. As the disease progresses, patients may notice:

• Blurred or fluctuating vision
• Dark spots or floaters
• Difficulty seeing at night
• Sudden vision loss

Treatment Options

Treatment depends on the stage and severity of disease. Options include intravitreal anti-VEGF injections to reduce swelling and suppress abnormal vessel growth, retinal laser treatment, and in advanced cases, vitrectomy surgery. Controlling blood sugar, blood pressure, and cholesterol also plays a critical role in slowing progression.