Proliferative diabetic retinopathy is the more advanced stage of the disease. You may experience vision changes and other symptoms. Treatments may include laser or injection therapy.

People with diabetes have a higher risk of developing a complication known as diabetic retinopathy.

Over time, diabetes often damages the small blood vessels, including the tiny blood vessels in the retina, which is the light-sensitive layer of tissue at the back of the eyeball.

This damage can progress to an advanced stage called proliferative diabetic retinopathy. If left untreated, it can lead to vision changes and blindness.

This article provides more detail on the advanced stage of diabetic retinopathy, and what you can do to treat and manage the eye condition as part of your diabetes management plan.

Proliferative diabetic retinopathy is one of two major stages of diabetic retinopathy. It’s the more advanced stage, following non-proliferative diabetic retinopathy.

In the early stage of diabetic retinopathy, the blood vessels in the retina weaken. They can leak fluid into the macula in the middle of your retina, which is responsible for your central vision. You can experience some swelling, or macular edema, as a result.

As the disease progresses and you develop proliferative diabetic retinopathy, you begin to grow tiny new blood vessels inside your retina and the vitreous, which is the gel-like substance at the back of the eye.

This process is known as neovascularization. It occurs because your body is trying to overcome a lack of circulation depriving your retina of oxygen.

People may not have any symptoms during the non-proliferative stage. But when your retinopathy progresses to the more advanced form, you may begin to experience symptoms such as:

  • eye floaters
  • blurry or cloudy vision
  • dark or empty spot in the middle of your field of vision
  • trouble seeing at night

As with non-proliferative diabetic retinopathy, proliferative diabetic retinopathy can also be further divided into stages based on severity:

  1. Early: includes the presence of newly formed blood vessels
  2. High risk: includes more neovascularization and possibly vitreous or pre-retinal hemorrhage
  3. Severe: hemorrhages have blocked some of the back surface of the eye (fundus), or the center of the macula has become detached

However, even the early or milder stage of proliferative diabetic retinopathy is still an advanced form.

There’s no cure for diabetic retinopathy, and you cannot reverse it. However, treatment can be effective in slowing disease progression.

Maintaining proper diabetes management to keep blood sugar levels in a healthy range can prevent damage from occurring in the first place. If your current treatment is not effectively managing your diabetes, talk with your doctor to find a better option.

Regular eye exams are also recommended for people with diabetes. Your eye doctor may detect signs of impending damage before you develop any symptoms at all.

Treatment for proliferative diabetic retinopathy depends in part on how advanced the disease has become. By the time it has progressed to the proliferative stage, your doctor may recommend one or more of these types of treatments:


Vitrectomy is the surgical removal of the vitreous.

It’s long been used as a standard treatment for people experiencing hemorrhages in their vitreous as a result of proliferative diabetic retinopathy. It does, however, carry some risk of complications.

Anti-VEGF injections

Your doctor can inject an anti-vascular endothelial growth factor (anti-VEGF) medication into the white part of your eye to address vitreous hemorrhages. It can also slow neovascularization, which should slow or even improve vision loss.

This injection is a protein that stimulates the growth of new blood vessels.

Anti-VEGF injections can also treat macular edema and wet age-related macular degeneration (AMD).

Laser treatment

Also known as photocoagulation, laser treatment can address damaged blood vessels and help preserve some of your vision. One version is known as scatter laser treatment, or panretinal photocoagulation.

Blood sugar management

Managing your blood sugar levels is one of the best ways to help prevent, reduce the risk, or stop diabetic retinopathy from worsening.

High blood sugar levels are responsible for the damage to your blood vessels, including the ones in your eyes. Keeping them in your target range and maintaining your target A1C level can help you keep your eyes as healthy as possible and prevent additional damage.

Here are some frequently asked questions about proliferative diabetic retinopathy:

Can you have proliferative diabetic retinopathy with macular edema?

Yes, you can have both conditions.

What are the ICD codes for proliferative retinopathy?

The International Classification of Diseases, 10th revision (ICD-10) codes for proliferative retinopathy vary based on whether the person has type 1 or type 2 diabetes, as well as whether the proliferative retinopathy affects the right eye, left eye, or both eyes.

It’s further broken down into specific codes that take into account the presence or absence of macular edema and traction retinal detachment.

The American Academy of Ophthalmology maintains a chart of the relevant codes you can consult.

Can you reverse proliferative diabetic retinopathy?

With treatment, it may be possible to slow down or stop some damage to your vision. But you cannot restore your vision once it’s gone, and you can’t completely reverse proliferative diabetic retinopathy.

By the time you develop noticeable symptoms affecting your vision, you may have developed proliferative diabetic retinopathy.

Talk with your eye doctor about beginning treatment right away to stop it from worsening and to preserve or restore as much of your vision as possible.

In addition to treatment, managing your diabetes well can also help you keep your eyes as healthy as possible.