What is it?
Diabetic retinopathy is a complication of diabetes that affects the blood vessels of the retina. Over time these vessels can leak fluid or blood, or close. In more advanced stages, abnormal new vessels may grow on the surface of the retina (proliferative diabetic retinopathy).
Symptoms
The early stages often cause no symptoms. As the condition progresses, people may notice blurred or fluctuating vision, dark spots or floaters, or difficulty seeing at night. Swelling of the central retina (diabetic macular oedema) can reduce reading vision.
Possible causes
The underlying cause is long-term damage to the retinal blood vessels from diabetes. Abnormal new vessels can bleed into the vitreous gel or form scar tissue that pulls on the retina.
Risk factors
The risk increases with the duration of diabetes and with poorly controlled blood sugar, blood pressure and cholesterol. Pregnancy and kidney disease can also be associated with faster progression.
Diagnosis
Diagnosis is made during a dilated eye examination. Optical coherence tomography (OCT) detects and measures macular oedema, and fluorescein angiography may be used to assess blood flow in the retina.
Treatment options
Management starts with good control of blood sugar, blood pressure and cholesterol, together with the treating physician. Depending on the stage, eye treatment may include intravitreal injections, laser treatment, or vitrectomy for bleeding into the vitreous that does not clear or for tractional retinal detachment.
When urgent evaluation may be needed
Seek prompt evaluation if you notice a sudden drop in vision, a shower of new floaters or a shadow over part of your vision. These can be signs of bleeding inside the eye or of retinal detachment.
Follow-up
People with diabetes need regular retinal examinations, even when their vision seems normal. The interval between examinations depends on the stage of retinopathy and is set by the eye doctor.
Information on this website is educational and does not replace an in-person medical examination, diagnosis or individual medical advice.