Microaneurysms are tiny areas of swelling in the blood vessels of your eye. They can be a clue to worsening diabetic retinopathy and may indicate that you need treatment to help prevent vision loss.

Diabetes can sometimes lead to complications, including diabetic retinopathy. Microaneurysms — areas of swelling in the tiny blood vessels in your eye — are a common sign of this progressive, potentially serious complication.

Microaneurysms can sometimes leak and bleed, resulting in small hemorrhages within your retina. Blood may build up within the retina’s nerve fiber layer and appear flat and feathery — this is called a blot hemorrhage.

Retinal microaneurysms typically will not affect your vision, but their presence is an important clinical sign that diabetic retinopathy is progressing.

This article will discuss what these diabetic retinopathy microaneurysms are, why they happen, and how identifying and promptly treating them can help stop or slow the progression of this diabetes-related eye complication and possible vision loss.

Microaneurysms are stretched areas in the walls of your capillaries, the tiny blood vessels that carry blood to your eyes and other parts of your body.

Retinal microaneurysms are the first visible signs of diabetic retinopathy.

Your retina is the layer at the back of your eye near the optic nerve. It changes light into signals your brain can understand. When an eye doctor examines your eyes using magnification, they will see these microaneurysms as little red dots. The dots sometimes have yellow rings around them.

Aside from diabetes, other possible causes of microaneurysms include:

Developing more microaneurysms due to diabetic retinopathy is viewed as a sign of more advanced eye disease. They may also be related to other eye changes, such as worsening retinopathy or the aging process.

Microaneurysms are not the same as retinal hemorrhages, which are areas of bleeding inside your retina. These hemorrhages can range from tiny specks to larger bleeds.

Many conditions can cause hemorrhages, including eye trauma and ocular diseases such as hypertensive retinopathy.

Microaneurysms can eventually rupture, leading to dot and blot hemorrhages. Because the hemorrhages are so tiny, these areas of bleeding can look the same as microaneurysms in an eye exam.

Microaneurysms often have no symptoms, but they can sometimes damage your retina. Too much damage to your retina can lead to vision loss.

Microaneurysms can leak fluid and proteins into the macula (the critical central part of your retina), causing it to swell. When you have diabetes and the macula swells, the thickening from the additional fluid is called diabetic macular edema. When only the tiny blood vessels swell, it’s called a microaneurysm.

The macula has the most photoreceptors in your retina and produces clear, strong focus at the center of your vision. Swelling can interfere with your focus and lead to vision loss. About 1 in 15 people with diabetes will develop macular edema.

If the microaneurysms leak in parts of your retina other than the macula, you won’t have any symptoms. They can still be a good indicator that you may have diabetic retinopathy.

If you have diabetes, you may have high blood sugar levels. After a while, the sugar can damage blood vessels everywhere in your body, including in your eyes.

The sugar can cause the blood vessels to swell and leak, such as in microaneurysms. It also can cause diabetic retinopathy. Microaneurysm development is the first stage of diabetic retinopathy.

The stages are:

  1. mild nonproliferative retinopathy
  2. moderate nonproliferative retinopathy, which involves blockage in the vessels of the retina
  3. severe nonproliferative retinopathy, in which more retinal vessels narrow, reducing the flow of fresh oxygen
  4. proliferative retinopathy (the most advanced stage), which occurs when the oxygen-starved retina tries to compensate by growing new blood vessels, but they are abnormal and worsen the bleeding and fluid leakage

In the early stages, you can treat the microaneurysms by treating the conditions that are causing them, such as diabetes and high blood pressure. This typically includes:

  • keeping your blood sugar in your target range and lowering your A1C levels
  • managing your blood pressure
  • managing blood lipids, including cholesterol
  • having regular eye exams to monitor for diabetes-related eye disease

If microaneurysms have developed and leaked blood and fluid into your retina, this may cause diabetic macular edema with significant vision loss. At this point, your eye doctor may recommend:

  • laser treatment
  • injected anti-vascular endothelial growth factor (anti-VEGF) medications to stop new blood vessels from forming
  • injected corticosteroids

If you have injections, you may need to visit an eye doctor or specialist more regularly afterward to check the progression. If you have laser treatments, you may also need to return for follow-ups. Additional treatments may also be necessary.

Microaneurysms from diabetic retinopathy are areas of swelling in the tiny blood vessels of your eye. They are usually a sign of diabetic retinopathy, a complication of diabetes in which high blood sugar levels damage the blood vessels in your eye. This can lead to vision loss.

Microaneurysms may not cause symptoms at first unless they leak into the part of your eye called the macula. Spotting microaneurysms during regular eye exams can help your eye doctor identify diabetic retinopathy and recommend ways to slow its progression.