Diabetes retinal damage (diabetic retinopathy) occurs in both eyes and will affect most diabetic patients. Loosely defined as any damage to the blood vessels serving the light sensitive back of the eye (retina). Unlike other diabetic eye complications such as glaucoma and cataracts, diabetic retinopathy may go unnoticed at the onset though at its most severe it can lead to blindness. Progressive symptoms outlined by the Mayo Clinic are: spots or dark strings (floaters); blurriness; fluctuating vision; dark or empty areas; poor night and color vision; total loss of sight.
Those at higher risk of diabetic retinopathy are individuals with uncontrolled glucose levels, Hispanics and African-Americans, smokers, and individuals with high cholesterol and blood pressure. Pregnancy may worsen diabetic retinopathy, necessitating more frequent eye exams.
Diabetes Retinal Damage: Stages of Diabetic Retinopathy
Diabetic retinopathy is classified as either nonproliferative (NPDR) or proliferative (PDR) and categorized according to severity. Cases of NPDR are mild, moderate, or severe. Mild cases of NPDR refer to the first stages of blood vessel damage, when the vessel walls weaken. Moderate NPDR occurs when bulges form in the blood vessels (microaneurysms), leaking blood and fluid into the retina. Severe cases indicate complete closure of small blood vessels (capillaries) causing larger blood vessels to expand and nerve fibers in the retina to swell. Severe NPDR may also lead to macular edema, a condition affecting the part of the retina responsible for seeing fine details. PDR is the most severe of all forms of diabetic retinopathy. In this stage of the condition new blood vessels begin to grow in the retina and sometimes vitreous, leaking and creating scar tissue.
Diabetes Retinal Damage: Complications
Complications of diabetic retinopathy occur during the proliferative stage of the condition and are directly related to the formation of new blood vessels. When blood vessels begin to form, the resulting leaking can create hemorrhaging in the vitreous, leading to floaters in the least severe cases and blocked vision at it’s worst. Spots or vision loss can be a sign of retinal detachment due to the formation of scar tissue while the onset of glaucoma is the due to increased pressure from fluid within the eye. The occurrence of one or all of these complications can result in permanent blindness and immediate action is required. In order to slow the progression of PDR laser treatments and/or a virectomy (removal of blood from the vitreous) are essential. While shown to be effective these treatments are not cures. Thus it is important to detect diabetes retinal damage at the onset, working closely with your ophthalmologist and endocrinologist in the monitoring of glucose and overall eye health.
