What is diabetic retinopathy?

Learn about the causes of diabetic retinopathy and how this condition is treated and prevented.

We Know: All About Diabetic Retinopathy

What is diabetic retinopathy?

Diabetic retinopathy is an abnormal eye condition caused by diabetes which weakens the blood vessels surrounding the retina. Blood leaks into the fluid-filled center of the eye. Retinopathy damages the light-sensitive region called the macula, where visual acuity is sharpest. When diabetic retinopathy is left untreated or undetected, it leads blindness.

Who is at risk for diabetic retinopathy?

Individuals who suffer from Type 1 and Type 2 diabetes are at risk for diabetic retinopathy. The risk of developing retinopathy increases the longer the person has had diabetes. The following statistics compiled by the American Diabetes Association and the National Eye Institute show the prevalence of diabetic retinopathy:

  • 40-45% of Americans will develop retinopathy.
  • Individuals diagnosed with Type 1 diabetes for 20 years or more will develop retinopathy.
  • 21% of Type 2 diabetes sufferers will develop retinopathy.

What are the signs and symptoms of diabetic retinopathy?

Initially, there are no symptoms; however, individuals may start seeing flecks or spots of blood in their vision during the progression to advanced forms of the condition. Diabetic retinopathy can take years to develop and occurs in four stages:

  1. Mild Nonproliferative Retinopathy
    • Blood vessels around the retina begin to swell.
    • There is no interference with vision.
  2. Moderate Nonproliferative Retinopathy
    • The blood vessels that feed the retina are blocked.
  3. Severe Nonproliferative Retinopathy
    • More blood vessels are blocked so several areas of the retina don't get the proper supply of blood.
    • New blood vessels begin to grow around the retina to supply blood to the eye.
  4. Proliferative Retinopathy
    • New blood vessels grow around the retina and in the vitreous gel (fluid filling the eye).
    • The new blood vessels are fragile. Blood may leak, causing retinal swelling.
    • Scar tissue may form, shrinking the retina and causing retinal detachment.
    • Leads to blindness.

When left untreated, nonproliferative retinopathy leads to proliferative retinopathy. Macular edema can occur at any stage of diabetic retinopathy, but tends to happen during the more severe stages. Fluid leaking into the macula blurs vision. About half of all people with severe retinopathy have macular edema.

What options are available to treat diabetic retinopathy?

Laser surgery is used to treat the complications stemming from diabetic retinopathy. The methods of treatment include:

  • Photocoagulation
    • Laser burns are made around the retina to seal blood vessels and prevent further growth and leakage.
  • Scatter Photocoagulation
    • Used for proliferative retinopathy.
    • Hundreds of burns are made in a polka-dot pattern around the retina.
    • Reduces blindness by shrinking abnormal blood vessels. Must be completed before viteous hemorrage or retinal detachment occurs.
    • Requires 2 or more sessions.
  • Focal Photocoagulation
    • Is performed in the macula and prevents vision from getting worse.
  • Vitrectomy
    • An invasive procedure that drains blood and the vitreous gel from the center of the eye, replacing the fluid with a salt solution.

How is diabetic retinopathy prevented?

Diabetics should get a comprehensive dilated eye examination every year. Healthy lifestyle habits that include healthy diets, controlling cholesterol and blood pressure, and maintaining low blood sugar levels can aid in preventing diabetic retinopathy.

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