Understanding Diabetic Retinopathy: Causes, Types, and Management

3 Nov 2023Eye Health & General Information

Diabetic retinopathy is one of the most serious complications to affect diabetics. The cause for its gravity is simple: it can potentially lead to blindness.

This is why the awareness and management of diabetic retinopathy is vital for those who have diabetes. In this way, they can keep a lookout for the signs of the disease, as well as take steps to try and avoid its development.

Today, we’ll help you understand diabetic retinopathy, covering everything from its causes to the best ways to manage it.

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What is Diabetic Retinopathy?

What is Diabetic Retinopathy?

Diabetic retinopathy is a condition which affects the retina, the delicate light-sensitive layer of tissue at the back of the eye. In diabetic,s the blood vessels on the retina started to get occluded and develop abnormalities. 

The vessels may develop microaneurysms, for example, or small bulges. There may also be bleeding spots, or hemorrhages, on the retina. In the late stages of retinopathy, growth of abnormal new blood vessels develop which are fragile and prone to bleeding.

All these complications can lead to bleeding in the vitreous cavity (the compartment in the back of the eye) which can impede vision, tractional retinal detachment, or in the very terminal stages, severe glaucoma, which can result in vision loss and pain.

Shinagawa_Blog Piece Mockup_Oct 5-04Causes of Diabetic Retinopathy

The primary cause of diabetic retinopathy is long-term poorly controlled diabetes. The problem comes from chronically high blood sugar and the damage it causes to the tiny blood vessels in the retina.

While we’re still uncertain of the exact way high blood sugar leads to issues for these vessels, we do know that it is associated with lowered oxygen delivery. This suffocates the eye and causes the release of growth factors in the eye that encourages new blood vessels to grow. However, these new blood vessels are dangerous and damage the eye in ways mentioned above. 

Take note that people with all types of diabetes are at risk for diabetic retinopathy, so whether a patient has Type 1 or Type 2 diabetes does not matter. Moreover, the longer you have had diabetes, the higher the chances of having the condition.

There are other risk factors worth noting: High blood pressure, high cholesterol levels, and genetics.

Types of Diabetic Retinopathy

Generally speaking, we can categorise diabetic retinopathy into two types. The first is non-proliferative diabetic retinopathy (NPDR) and the second is proliferative diabetic retinopathy (PDR).

NPDR may be split further into other types according to severity, but typically, it indicates diabetic retinopathy that has not yet reached the point of abnormal new blood vessel growth (or proliferation) in the retina.

At its mildest, the retina can appear generally healthy, and patients have absolutely no symptoms, with only a microaneurysm or two in the retinal blood vessels to indicate it. At worst, there can be widespread bleeding within the retina.

A patient has progressed to PDR when blood vessels have begun to grow throughout the retina or blood has already found its way to the vitreous cavity. This is the last, most severe stage of the disease.

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Management and Treatment Options

As we noted earlier, diabetic retinopathy can lead to vision loss. Some of this vision loss can be irreversible.

Fortunately, acting as soon as possible can prevent worse vision loss. In fact, it can even reduce the risk of going blind by 95%.

Treatments for Diabetic Retinopathy

Below are some of the options available to people with the disease:

  1. Laser treatment – Laser for the treatment of proliferative diabetic retinopathy has been the mainstay for decades, where a laser is used to achieve panretinal photocoagulation. This helps prevent the growth of these abnormal fragile vessels.
  2. Injections – Anti-VEGF (vascular endothelial growth factor) injections can help manage diabetic retinopathy and reduce swelling. The injections stop the abnormal blood vessels from leaking, growing, and bleeding under the retina.
  3. Eye surgery – Surgeries like vitrectomy is sometimes necessary for advanced cases if there is extensive bleeding in the eye or started to develop retinal detachment.

Management Tips for Diabetic Retinopathy

Managing diabetes is actually the best way to lower the risk of diabetic retinopathy. With good sugar control, even those who already have diabetic retinopathy can reduce the chances of it progressing to a more severe stage.

The usual advice applies here: lifestyle changes like regular meals and a healthy diet can do a lot to control blood sugar. The same goes for exercise and performing maintenance treatment for things that are added risk factors, like hypertension.

Moreover, those with diabetes should have a regular appointment with their eye specialist. Even if there is no diabetic retinopathy at this moment, an annual check is still necessary to pick up any issues before it becomes severe. Early detection is the best way to avoid the worst outcome of this disease.

Book an appointment to check for diabetic retinopathy today

Diabetic retinopathy is clearly a serious disease with potentially grave outcomes. Diabetics would do well to be on the lookout for its symptoms.

Fortunately, eye doctors like ours at Shinagawa Eye Centre can help you identify this disease as well as manage it if it does appear. For best results, you should get regular eye examinations, as mentioned earlier, in order to find and address it early on.

Call us to enquire or book an appointment for assessment as soon as possible. If you do have diabetic retinopathy, we can go over your management and treatment options with you.