Diabetic Retinopathy
Diabetic retinopathy is a retinal disease caused by long-term high blood sugar damaging the blood vessels of the retina, and is one of the major causes of vision loss in people with diabetes.
Prof. Dr. Fevzi Şentürk
Ophthalmology · Istanbul
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Diabetic retinopathy develops when the retinal blood vessels are gradually damaged due to diabetes, and it requires regular monitoring.
What Is Diabetic Retinopathy?
Diabetic retinopathy is a retinal disease caused by the damage that long-term high blood sugar levels cause to the retina’s blood vessels. It can occur in people with both Type 1 and Type 2 diabetes and is one of the major causes of vision loss in people with diabetes.
The disease usually progresses slowly and may not cause noticeable symptoms in the early stages, which makes regular dilated eye examinations essential.
What Are the Stages of Diabetic Retinopathy?
Non-Proliferative Diabetic Retinopathy (Early Stage)
In this stage, small bulges in the vessel walls (microaneurysms), dot-shaped haemorrhages, and leakage may be seen. Findings can range from mild to more advanced.
Proliferative Diabetic Retinopathy (Advanced Stage)
Due to insufficient nourishment of retinal tissue, abnormal and fragile new blood vessels (neovascularisation) grow on the retina. These vessels can bleed, form scar tissue, and lead to retinal detachment.
Diabetic Macular Oedema
Diabetic macular oedema can develop at any stage of diabetic retinopathy when fluid leaking from retinal vessels accumulates in the macula. This condition can directly affect central vision.
What Are the Symptoms of Diabetic Retinopathy?
- Often no noticeable symptoms in the early stages
- Blurred or wavy vision
- Floaters
- Dark or empty areas in the visual field
- Changes in colour perception
- Sudden vision loss in advanced stages
How Is Diabetic Retinopathy Diagnosed?
Diagnosis and monitoring involve:
- A dilated eye examination
- Optical coherence tomography (OCT) — to assess macular oedema
- Fluorescein angiography — to map vessel leakage and blockages
All individuals diagnosed with diabetes are advised to undergo dilated eye examinations at regular intervals.
How Is Diabetic Retinopathy Treated?
Blood Sugar and General Health Control
Keeping blood sugar, blood pressure and cholesterol levels under control is one of the fundamental steps in slowing disease progression.
Laser Photocoagulation
Laser treatment can be applied to control abnormal vessel growth and protect retinal tissue. This method is particularly used in the proliferative stage.
Intravitreal Anti-VEGF Injections
For diabetic macular oedema and proliferative diabetic retinopathy, anti-VEGF medications injected into the eye can help reduce leakage and suppress abnormal vessel growth.
Vitrectomy Surgery
In advanced diabetic retinopathy, if vitreous haemorrhage, scar tissue, or retinal detachment has developed, vitrectomy surgery may be required.
What Should Be Monitored With Diabetic Retinopathy?
- Regular monitoring of blood sugar levels
- Attending dilated eye examinations at the intervals recommended by the doctor
- Seeking prompt attention for sudden vision changes
- Keeping associated risk factors such as blood pressure and cholesterol under control
- Considering smoking cessation, if applicable
When diabetic retinopathy is detected early and monitored regularly, treatment options aimed at preserving vision can be evaluated more effectively.
Frequently Asked Questions
What is diabetic retinopathy?
Diabetic retinopathy is a retinal disease caused by the damage that long-term high blood sugar levels cause to the retina's blood vessels. This can lead to leakage, blockage, or abnormal new vessel growth.
What are the stages of diabetic retinopathy?
The disease is generally classified into non-proliferative (early stage) and proliferative (advanced stage). In the non-proliferative stage, small changes occur in the vessel walls, while in the proliferative stage abnormal new vessels grow on the retina.
What is diabetic macular oedema?
Diabetic macular oedema is swelling caused by fluid leaking from retinal vessels and accumulating in the macula, and it is one of the main causes of vision loss related to diabetic retinopathy.
What are the symptoms of diabetic retinopathy?
In the early stages there may be no noticeable symptoms. As it progresses, blurred vision, floaters, dark areas in the visual field, and changes in colour perception may occur.
How often should people with diabetes have an eye exam?
Regular dilated eye examinations are recommended after a diabetes diagnosis. The frequency is determined by the doctor based on the duration of diabetes, blood sugar control, and existing retinal findings.
How is diabetic retinopathy treated?
Treatment depends on the stage of the disease. Blood sugar control, laser photocoagulation, intravitreal anti-VEGF injections, and vitrectomy surgery in advanced stages are among the treatment options.
Does blood sugar control affect diabetic retinopathy?
Yes. Keeping blood sugar, blood pressure and cholesterol levels under control plays an important role in slowing the development and progression of diabetic retinopathy.
What happens if diabetic retinopathy is left untreated?
Untreated advanced diabetic retinopathy can lead to retinal detachment and serious, sometimes permanent, vision loss. Regular follow-up and timely treatment are therefore important.
Does diabetic retinopathy occur in every person with diabetes?
No, but the risk increases with the duration of diabetes and inadequate blood sugar control. Regular eye examinations are important for catching early signs.
Treatments often evaluated together
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Intravitreal Injection
Intravitreal injection is a procedure used to treat retinal diseases such as macular degeneration, diabetic macular oedema and retinal vein occlusion, in which medication is delivered directly into the eye.
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Argon Laser Photocoagulation
Argon laser photocoagulation uses laser energy to seal abnormal retinal blood vessel areas or the tissue around retinal tears, and is used for conditions such as diabetic retinopathy, retinal tears and retinal vein occlusion.
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Retinal Detachment
Retinal detachment occurs when the retina separates from its underlying supporting tissue and is a serious eye condition that requires urgent evaluation.
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