Diabetic Retinopathy: Stages, Causes, Symptoms, Diagnosis and Treatment

Diabetic retinopathy is an eye disease develpoed in all kind of dibetic people in which retina will be damaged due to diabetes

Updated: June 16, 2022

Diabetic retinopathy is an eye disease developed in all kind of diabetic people in which  retina will be damaged due to diabetes causing blindness.


Stages of Diabetic Retinopathy:

There are two stages of diabetic retinopathy.


Non-Proliferative Diabetic Retinopathy(NPDR):

  • Many people with diabetes have this early stage of diabetic eye disease. In this stage the retina will swell because of  tiny blood vessels leakage.
  • When the macula swells, it is called macular edema. This is the most common reason why people with diabetes lose their vision. In some cases blood cannot reach the macula leading to macular ischemia. This will effect your vision too.


Proliferative Diabetic Retinopathy(PDR):

This is the more advanced stage of diabetic eye disease. This stage occurs when the retina starts growing new blood vessels. This is called neovascularization. These can burst and bleed causing vitreous hemorrhage and blur the vision, because these new blood vessels are fragile. If the fragile blood vessels only bleed a little, a few dark floaters can be seen which goes away after few hours. If they bleed a lot, it might block all vision. These new blood vessels can form scar tissue. Scar tissue can cause problems with the macula or lead to a detached retina. PDR is very serious, and can damage both your central and peripheral vision.

Symptoms of Diabetic Retinopathy:

Usually there is no early signs in diabetic retinopathy . Sometimes even macular edema, which can cause rapid vision loss, may not have any warning signs. However, a person with macular edema will have blurred vision, making it hard to do things like read or drive. In some cases, the vision will get better or worse during the day. Typical symptoms of retinopathy may include one or more of the following signs.

  • Sudden changes in vision
  • Distorted vision
  • Blurred vision
  • Floaters in your vision
  • Seeing dark spots or patches
  • Reduction in night vision
  • Loss of vision


Cause of Diabetic Retinopathy:

Diabetic retinopathy is caused by prolonged high blood glucose levels. Over time, high sugar glucose levels can weaken and damage the small blood vessels with in the retina causing swelling of the retina. Then there will be insufficient supply of oxygen to the retina leading to growth of abnormal vessels which effects the vision. Retinopathy can also develop faster due to high blood pressure. Good blood glucose control helps to lower diabetes retinopathy risks.


Diagnosis of  Diabetic Retinopathy:

Methods of eye examination that detect diabetic retinopathy includes:


Visual accuracy test:

Different eye chart is used to measure how well a person sees  or read at various distances.


Pupil Dilation:

Eye drops will be dropped in the eye to dilate the pupil, so that the retina can be closely examined for the sign of diabetic retinopathy. Close-up vision may remain blurred for several hours after this test.


Fluorescein Angiography:

A fluoresce that is a Yellow dye is injected into a vein, usually in your arm. The dye travels through your blood vessels and a special camera takes photos of the retina as the dye travels throughout its blood vessels. This shows if any blood vessels are blocked or leaking fluid. It also shows if any abnormal blood vessels are growing.


Optical Coherence Tomography (OCT):

This is another way to look closely at the retina. A machine scans the retina and provides detailed images of its thickness, which will help measure swelling of your macula.


Ophthalmoscopy:

Close examination of retina can be done through a slit lamp biomicroscope with a special magnifying lens.

Treatment of Diabetic Retinopathy:

Treatment options may include:


Medical Control:

Controlling your blood sugar and blood pressure keeps your eye's blood vessels healthy. Hence can reduce the risk of vision loss.


Medicine:

Anti-VEGF and steroid are the medicines given in the form of injection to  reduce macular swelling. This will help slowing vision loss and perhaps improving vision.

Laser Surgery:

Laser surgery is used to block leaking blood vessels. This can reduce swelling of the retina. Laser surgery can also help shrink blood vessels and prevent them from growing again.

Vitrectomy:

This is suggested in advance stage of PDR. Vitreous gel and blood from leaking vessels in the back of your eye will be removed, which allows light rays to focus properly on the retina again. Scar tissue also might be removed from the retina.



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