When long-term diabetes causes progressive damage to the eye's retina, this condition is referred to as Diabetic Retinopathy. It is the most common diabetic eye disease that occurs when blood vessels in the retina change. Sometimes these vessels swell and leak fluid or even close off completely. In other cases, abnormal new blood vessels grow on the surface of the retina. There are two stages of Diabetic Retinopathy: Nonproliferative diabetic retinopathy (NPDR) and Proliferative diabetic retinopathy (PDR). NPDR is an early stage of Diabetic Retinopathy in which damaged blood vessels in the retina begin to leak extra fluid and small amounts of blood into the eye. Sometimes, deposits of cholesterol or other fats from the blood may leak into the retina. Diabetic Retinopathy is the leading cause of blindness in working-age Americans.
The disease occurs when blood-sugar levels are high for extended periods of time, it can cause damage to the capillaries (tiny blood vessels) that supply blood to the retina. Over time, these blood vessels begin to leak fluids and fats, causing edema (swelling). Eventually, these small blood vessels can close off (called ischemia). These problems are a sign of NPDR and can lead to vision problems if existing blood vessels leak fluid into the retina. PDR can lead to visual disruption if abnormal new blood vessels hemorrhage and leak fluid.
As diabetic eye problems are left untreated, PDR can develop. Blocked blood vessels from ischemia can lead to the growth of new abnormal blood vessels on the retina (called neovascularization) which can damage the retina by causing wrinkling or retinal detachment. Neovascularization can even lead to glaucoma, damage to the optic nerve that carries images from your eye to your brain.
The only way to detect diabetic retinopathy and to monitor its progression is through a comprehensive eye exam
There are several parts to the exam:
People with both Type 1 and Type 2 diabetes are at risk as well as women with gestational diabetes.
Several factors can influence the development and severity of diabetic retinopathy, including:
Treatment of diabetes is also considered treatment for Diabetic Retinopathy. The best treatment for diabetic retinopathy is to prevent it. Strict control of blood sugar will significantly reduce the long-term risk of vision loss. Treatment usually won't cure diabetic retinopathy nor does it usually restore normal vision, but it may slow the progression of vision loss.
Laser surgery can be used to treat Diabetic retinopathy. It shrinks abnormal new vessels and reduces macular swelling.
Management of diabetes is the best way to prevent vision loss. Yearly diabetic retinopathy screenings with a dilated eye exam is important to detection in the early stages. If pregnant, it is recommended to have regular eye exams throughout the pregnancy, because pregnancy can sometimes worsen diabetic retinopathy.
This document is provided for informational purposes only. Please consult an eye care professional about symptoms that may require medical attention and may or may not be covered by your medical plan and/or routine vision plan.
Sources: American Academy of Ophthalmology (AAO) - www.aao.org
Kd: Diabetic Retinopathy 10-13