Diabetic retinopathy is the leading cause of acquired blindness among Americans under the age of 65. The great majority of this blindness can be prevented with proper examination and treatment by ophthalmologists (EyeMDs). An extraordinary amount of research has already been completed, and is relied upon heavily by practicing ophthalmologists, in the treatment of patients with diabetes. Unfortunately, patients who are not properly referred for evaluation and management or those who, for any reason, fail to get proper care from an ophthalmologist, are at the greatest risk of vision loss.

If you have diabetes mellitus, or sugar diabetes, your body does not use and store sugar properly. High blood-sugar levels can damage blood vessels in the retina, the nerve layer at the back of the eye that senses light and helps send images to the brain. The damage to the retinal vessels is referred to as Diabetic Retinopathy.

 
     
  Types of Diabetic Retinopathy  
 

There are two types of diabetic retinopathy: nonproliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR).

NPDR, commonly known as background retinopathy, is an early stage of diabetic retinopathy. In this stage, tiny blood vessels within the retina leak blood or fluid. The leaking fluid causes the retina to swell or to form deposits called exudates. Many people with diabetes have mild NPDR, which usually does not affect their vision. When vision is affected it is the result of macular edema and/or macular ischemia. Click on the image below for a complete diagram.

 
     
 
Macular Edema is swelling or thickening of the macula, a small area in the center of the retina that allows us to see fine details clearly. The swelling is caused by fluid leaking from retinal blood vessels. Vision loss may be mild to severe, but even in the worst cases, peripheral vision continues to function.  
 
     
  Macular Ischemia occurs when small blood vessels (capillaries) close. Vision blurs because the macula no longer receives sufficient blood supply to continue working properly.  
     
  Proliferative Diabetic Retinopathy (PDR) carries the greatest risk of visual loss of the conditions discussed thus far. The condition is characterized by the development of neovascularization on or adjacent to the optic nerve and vitreous or pre-retinal hemorrhage (hemorrhage in the vitreous humor or in front of the retina). PDR usually occurs in eyes with advanced background diabetic retinopathy and is thought to be secondary to ischemia of the retina. It has been theorized that a “neovascular growth factor,” acting as a local hormone, may cause the development of neovascularization. Unfortunately, the neovascular vessels are abnormal and have a tendency to break and bleed into the vitreous humor of the eye. In addition to sudden vision loss, this may lead to more permanent complications, such as tractional retinal detachment and neovascular glaucoma.  
 

 

  
 
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