What is diabetic retinopathy?

What are the stages of diabetic retinopathy?

How does diabetic retinopathy cause vision loss?

Does diabetic retinopathy have any symptoms?

What are the symptoms of proliferative retinopathy if bleeding occurs?

How are diabetic retinopathy and macular edema detected?

 

Laser Treatment

 

Related Videos

Nonproliferative Diabetic Retinopathy

Proliferative Diabetic Retinopathy (PDR)

Macular edema and ischemia

 

Eye Anatomy

List of Diseases

 

Information provided courtesy of the
National Eye Institute, US National Institutes of Health

 
 

Diabetic Retinopathy


What is diabetic retinopathy?

Diabetic retinopathy is the most common diabetic eye disease and a leading cause of blindness in American adults. It is caused by changes in the blood vessels of the retina.

In some people with diabetic retinopathy, blood vessels may swell and leak fluid. In other people, abnormal new blood vessels grow on the surface of the retina. The retina is the light-sensitive tissue at the back of the eye. A healthy retina is necessary for good vision.

If you have diabetic retinopathy, at first you may not notice changes to your vision. But over time, diabetic retinopathy can get worse and cause vision loss. Diabetic retinopathy usually affects both eyes.

amd1 diabret

Normal vision

Same scene viewed by a person with diabetic retinopathy

 

What are the stages of diabetic retinopathy?

Diabetic retinopathy has four stages:

1. Mild Nonproliferative Retinopathy
At this earliest stage, microaneurysms occur. They are small areas of balloon-like swelling in the retina's tiny blood vessels.


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Nonproliferative
Diabetic Retinopathy

 

2. Moderate Nonproliferative Retinopathy
Other blood vessels may leak fluid into the retina causing it to swell and function poorly thus reducing vision.

3. Severe Nonproliferative Retinopathy
Many more blood vessels are blocked, depriving several areas of the retina with their blood supply. These areas of the retina send signals to the body to grow new blood vessels for nourishment.

4. Proliferative Retinopathy
At this advanced stage, the signals sent by the retina for nourishment trigger the growth of new blood vessels. This condition is called proliferative retinopathy. These new blood vessels are abnormal and fragile. They grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye. By themselves, these blood vessels do not cause symptoms or vision loss. However, they have thin, fragile walls. If they leak blood, severe vision loss and even blindness can result. (Laser treatment for proliferative retinopathy)


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Proliferative Diabetic Retinopathy (PDR)

 


How does diabetic retinopathy cause vision loss?

Blood vessels damaged from diabetic retinopathy can cause vision loss in two ways:


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Macular edema
and ischemia

1. Fragile, abnormal blood vessels can develop and leak blood into the center of the eye, blurring vision. This is proliferative retinopathy and is the fourth and most advanced stage of the disease.

2. Fluid can leak into the center of the macula, the part of the eye where sharp, straight-ahead vision occurs. The fluid makes the macula swell, blurring vision. This condition is called macular edema. It can occur at any stage of diabetic retinopathy, although it is more likely to occur as the disease progresses. About half of the people with proliferative retinopathy also have macular edema.

 


Does diabetic retinopathy have any symptoms?

Often there are no symptoms in the early stages of the disease, nor is there any pain. Don't wait for symptoms. Be sure to have a comprehensive dilated eye exam at least once a year.

Blurred vision may occur when the macula-the part of the retina that provides sharp central vision-swells from leaking fluid. This condition is called macular edema.

If new blood vessels grow on the surface of the retina, they can bleed into the eye and block vision.

 


What are the symptoms of proliferative retinopathy if bleeding occurs?

At first, you will see a few specks of blood, or spots, "floating" in your vision. If spots occur, see your eye care professional as soon as possible. You may need treatment before more serious bleeding occurs. Hemorrhages tend to happen more than once, often during sleep.

Sometimes, without treatment, the spots clear, and you will see better. However, bleeding can recur and cause severely blurred vision. You need to be examined by your eye care professional at the first sign of blurred vision, before more bleeding occurs.

If left untreated, proliferative retinopathy can cause severe vision loss and even blindness. Also, the earlier you receive treatment, the more likely treatment will be effective.

 

How are diabetic retinopathy and macular edema detected?

Diabetic retinopathy and macular edema are detected during a comprehensive eye exam that includes:

1. Visual acuity test
This eye chart test measures how well you see at various distances.

2. Dilated eye exam
Drops are placed in your eyes to widen, or dilate the pupils. This allows the eye care professional to see more of the inside of your eyes to check for signs of the disease. Your eye care professional uses a special magnifying lens to examine your retina and optic nerve for signs of damage and other eye problems. After the exam, your close-up vision may remain blurred for several hours.

3. Optical Coherence Tomography and Fluorescein Angiography
Optical coherence tomography is a non-contact, non-invasive, high resolution scan of your retina that can show retinal swelling (macular edema) even before it is visible to your doctor on dilated eye exam. The doctor may also recommend fluorescein angiography, a test in which a special dye is injected into your arm. Pictures are taken as the dye passes through the blood vessels in your retina. This allows your doctor to identify any leaking blood vessels or any new or neovascular proliferation.