Diabetic retinopathy is the leading cause of blindness among American adults. Approximately, 25% of current diabetics, both with type 1 and type 2 diabetes, have some form of the disease. The risk of developing diabetic retinopathy increases with the age of the diabetic person and the duration of the disease. It is estimated that 90% of diabetics may experience some form of diabetic retinopathy over the course of their life. However, only a small percentage of those developing diabetic retinopathy have serious vision problems and even a smaller percentage become blind.

What is diabetic retinopathy?

Diabetic retinopathy is a diabetes complication that affects the eyes. This occurs when high blood sugar levels cause damage to blood vessels that nourish the retina. These vessels weaken, leak fluid and blood, and fail to provide nutrients necessary for good health in the retina. Left untreated, diabetic retinopathy can result in severe visual loss, including blindness. Unfortunately, the development of diabetic retinopathy cannot be prevented. 

Symptoms

Individuals might not have symptoms in the early stages of diabetic retinopathy. The longer someone has diabetes and the less controlled their blood sugar is, the more likely they are to develop this eye complication. As the condition progresses, symptoms may include:

• Spots or dark string floating in your vision (floaters)
• Blurred vision
• Fluctuating vision
• Impaired color vision
• Dark or empty areas in your vision
• Vision loss

Diabetic retinopathy usually affects both eyes.

Diagnosis & Treatment

Diabetic retinopathy is located through a comprehensive eye exam. Regular eye exams also protect against progression of diabetic retinopathy. If found, fluorescein angiography is performed to determine the extent of blood vessel leakage. Treatment is based on the location of the disease and degree of damage to the retina. Treatment options can vary and can range from careful monitoring to laser treatments and injections.

Non-proliferative vs. Proliferative Diabetic Retinopathy

Diabetic retinopathy can take two forms, non-proliferative retinopathy and proliferative retinopathy. During the early stage of the disease (non-proliferative retinopathy), small blood vessels in the retina leak clear fluid into the surrounding tissue which causes swelling. Abnormal blood vessels may also hemorrhage or leak fats and proteins which form deposits. If fluid collects in the macula, diminished or blurred vision will result. However, if leakage or deposits occur in the outer edges of the retina, no symptoms may be noticed. Sight is not usually seriously affected in these cases. In fact, the condition does not progress in 80% of patients. However, the early stages of diabetic retinopathy is a warning sign and can progress into the more serious stage of the disease, proliferative retinopathy.

Proliferative diabetic retinopathy occurs when new abnormal blood vessels grow over the retina and may grow into the clear vitreous. These new vessels bleed into the vitreous, blocking light from reaching the retina and causing cloudy vision. Patients can also experience retinal detachment, where connective tissue and abnormal blood vessels contract and pull the retina away from underlying structures. Proliferative retinopathy affects approximately 5% of all diabetics and becomes more likely with increased duration if diabetes. If left untreated, proliferative retinopathy can lead to blindness.

Ophthalmologist Dimple Modi, MD, MPH is specially trained to evaluate, diagnose and treat diabetic retinopathy. Call the Eye Center to schedule an appointment today. 762.235.3200