Diabetic retinopathy is a condition that occurs as a result of damaged blood vessels of the retina in people who have diabetes. Diabetic retinopathy can develop whether you have type 1 or type 2 diabetes. While you may start out with only mild vision problems, you can eventually go blind. Untreated diabetic retinopathy is one of the most common causes of blindness in the United States. It is also the most common disease of the eye in diabetics.
Early Diabetic Retinopathy
Early diabetic retinopathy may also be known as nonproliferative diabetic retinopathy (NPDR). It is called “nonproliferative” because during the early stages of diabetic retinopathy the eye does not make new blood vessels. During early retinopathy, damaged blood vessels often leak blood and fluid into the eye. In some cases, the center of the retina, or macula, begins to swell. This causes a condition called macular edema.
Advanced Diabetic Retinopathy
Advanced diabetic retinopathy is sometimes called proliferative diabetic retinopathy because this is the stage of retinopathy in which new blood vessels begin to grow within the retina. These new blood vessels are usually abnormal, and grow in the center of the eye.
Diabetic retinopathy is caused by excess levels of sugar in the blood. This excess sugar damages the blood vessels that supply the retina with blood. High blood pressure is also a risk factor for retinopathy.
The retina is a layer of tissue in the back of the eye. It is responsible for changing images that the eye sees into nerve signals that the brain can understand. When blood vessels of the retina are blocked, this cuts off some of the retina’s blood supply. This loss of blood flow can cause partial blindness. When the eye tries to replace the blocked blood vessels with new ones, they often do not form properly. These new blood vessels leak and create scar tissue that can cause loss of vision.
The longer you have diabetes, the higher your chances of developing diabetic retinopathy become. Nearly everyone who has diabetes for more than 30 years will show some signs of retinopathy. Keeping your diabetes under control can help slow the progression.
Women with preexisting diabetes who are pregnant or are planning to become pregnant should have a comprehensive eye exam to determine if they have retinopathy.
It’s uncommon to have symptoms during the early stages of this condition. Symptoms are most commonly seen in both eyes and can include:
- floaters or dark spots appearing in your vision
- difficulty seeing at night
- blurred vision
- loss of vision
- difficulty distinguishing colors
The symptoms of diabetic retinopathy often don’t appear until there is major damage inside the eye. To prevent unseen damage, you should get eye exams regularly to monitor your eye health.
Diabetic retinopathy can be diagnosed with a dilated eye exam. This involves the use of eye drops that make the pupils open wide, allowing the doctor to get a good look at the inside of the eye. The doctor will check for:
- abnormal blood vessels
- blocked blood vessels
- detachment of your retina
A fluorescein angiography test may also be performed. The doctor injects a dye into the arm, allowing them to track how the blood flows in the eye. Pictures are taken of the dye circulating inside the eye to determine which vessels are blocked, leaking, or broken.
An OCT exam is an imaging test that produces images of the retina that allow your physician to determine its thickness. OCT exams help determine how much fluid, if any, has accumulated in the retina.
Treatment options are limited for patients with early diabetic retinopathy. Your doctor may want to perform regular eye exams to monitor eye health in case treatment becomes necessary. An endocrinologist can help to slow the progression of retinopathy by tackling diabetes.
In advanced diabetic retinopathy, treatment depends on type and severity of retinopathy.
Laser phototcoagulation surgery, which uses a laser to control or sop leakage, can help prevent vision loss.
Other treatments might include:
- scatter laser treatment, which uses a laser to shrink abnormal blood vessels in the eye
- vitrectomy, which involves the removal of blood from the vitreous fluid of the eye
For people with diabetes, maintaining healthy blood pressure, blood sugar, and cholesterol levels are a vital for preventing diabetic retinopathy.
Other ways to help prevent the condition include quitting smoking and getting regular, moderate exercise several times a week.
Be mindful of any changes you may notice in your vision. Annual eye exams are also recommended.