What is Diabetic Retinopathy

Diabetic retinopathy is a complication of diabetes caused by damage to the blood vessels in the tissue of the retina. The retina is responsible for converting light that hits the eye into signals that can be interpreted by the brain, producing images. When the blood vessels of the retina are damaged, they leak and distort vision. There are two types of this diabetic eye problem, nonproliferative diabetic retinopathy and proliferative diabetic retinopathy. Nonproliferative diabetic retinopathy is milder and usually symptomless. Proliferative diabetic retinopathy is more advanced and includes the formation of new, abnormal blood vessels in the retina. Diabetic retinopathy is a leading cause of blindness in the United States, and one-third of the people worldwide with diabetes show signs of diabetic retinopathy.

Diabetic Retinopathy Causes

High glucose levels cause diabetic retinopathy. The excess sugar blocks the tiny blood vessels that nourish the retina. In nonproliferative diabetic retinopathy, the walls of the blood vessels in the retina weaken and tiny bulges form and leak fluid and blood into the retina. In proliferative diabetic retinopathy, abnormal blood vessels begin to develop and leak a clear, jelly-like substance into the center of the eye.

Diabetic Retinopathy Signs and Symptoms

Diabetic retinopathy usually doesn’t present symptoms in the early stages. Symptoms may only become noticeable at advanced stages and, in some cases, a sudden loss of vision is the only detectable symptom.

Signs of diabetic retinopathy may include:

• Blurred vision
• The impairment of color vision
• Floaters (transparent and colorless spots and dark strings that float in the field of vision)
• Patches or streaks that interfere with the field of vision
• Poor night vision
• Sudden and total loss of vision

Diabetic Retinopathy Diagnosis

Although diabetic retinopathy usually shows no symptoms, an ophthalmologist can detect the signs. That’s why it’s vital that a patient with diabetes gets an eye exam once or twice annually. An eye specialist will use a dilated eye exam, fluorescein angiography or optical coherence tomography (OCT) to make a diagnosis. Some things the doctor will be looking for include:

• Abnormalities in the blood vessels, optic nerve or retina
• Cataracts
• Changes in eye pressure or overall vision
• New blood vessels
• Retinal detachment
• Scar tissue

Diabetic Retinopathy Treatment

Diabetic retinopathy treatment begins with slowing the progression of the condition. Managing glucose levels does this. Good blood sugar levels can significantly slow the advancement of diabetic retinopathy. When procedures are used, some treatment options for proliferative and nonproliferative retinopathy include:

• Focal laser treatment: This procedure is performed in a doctor’s office or eye clinic. Lasers burns are used to seal leaking blood vessels in the retina. This process, called photocoagulation, slows or stops the release of blood from abnormal blood vessels and build up of fluid in the eye. Patients may experience blurry vision for 24 hours following this procedure.
• Scatter laser treatment: This procedure often requires a series of two to three treatments for best results. Scattered laser burns are applied to the retina, away from the strongest area of vision. The burns shrink abnormal blood vessels and cause them to scar. Patients may experience a loss of peripheral vision or night vision after this treatment. Blurry vision may occur for 24 hours following this procedure.
• Vitrectomy: A vitrectomy is performed in a hospital or surgery center under local or general anesthesia. During this procedure, some of the eye’s clouded vitreous is removed and replaced with a clear liquid or gas. The body absorbs the liquid or gas, creating new, clear vitreous. Patients may have to wear an eye patch after a vitrectomy and may have blurry vision for a few weeks following this procedure.
• Injecting eye medication: Medications called vascular endothelial growth hormone (VEGF) inhibitors may be injected into the vitreous to treat diabetic retinopathy. They can help prevent the growth of new, abnormal blood vessels by interrupting the body’s growth signals to generate new blood vessels. These medications may be used in conjunction with laser treatments.

Diabetic Retinopathy Risk Factors and Complications

There are a number of diabetic retinopathy risk factors and complications of diabetic retinopathy. In some cases, lifestyle choices can reduce risk.

The Risk Factors of Diabetic Retinopathy Include:

• Duration of diabetes
• Poor control of blood sugar levels
• High blood pressure
• High cholesterol
• Pregnancy
• Tobacco use
• Being African-American, Hispanic or Native American

The Complications of Diabetic Retinopathy Include:

• Retinal detachment
• Vitreous hemorrhage
• Glaucoma
• Blindness

Learn More About Diabetic Retinopathy

Patients who have difficulty controlling their blood sugar should talk to their doctor about diabetic retinopathy. Those who are experiencing blurred vision, impaired color vision, patches or streaks in their vision, poor night vision, or any loss of vision should also speak with their doctor about this condition. Patients who have had diabetes for a long time should also talk to their doctor about diabetic retinopathy. Find out more by talking to your Baptist Health medical provider.