Diabetic retinopathy is a complication of long-standing diabetes mellitus caused by persistently raised or uncontrolled blood sugar levels. Adequate control of blood sugar and other risk factors such as high blood pressure can significantly delay or even prevent the progression of diabetic retinopathy.
Early stage retinopathy
During this stage of diabetic retinopathy, there are often no symptoms and no specific treatment is required. Instead, regular checkups with an ophthalmologist or eye disease specialist who can monitor the progression of the retinopathy is advised. Maintaining rigid control of blood sugar also decreases the risk of disease progression as does control of blood pressure. Cessation of any smoking habit is also recommended as smoking may increase the risk of damage to the microvessels in the eye.
Stage two retinopathy
In this stage, routine eye screening is recommended as the formation of new blood vessels that are brittle and prone to rupture occurs during this stage. There is therefore an increased risk of blood leaking into the retina and blurring vision.
Stages three retinopathy
This more advanced stage of retinopathy typically involves bleeding from microanuerysms and newly formed blood vessels, which causes blurred vision. In addition, there may be involvement of a highly sensitive part of the eye responsible for central vision called the macula. Treatment at this stage may involve:
High energy light beams or laser beams are used to coagulate the tissue in leaky blood vessels. The laser beam is directed into the eyes after numbing them with a local anesthetic and the laser beam seals the damaged blood vessels, preventing further leakage.
Intravitreal anti-VEGF injections
These injections are used in the treatment of age-related macular degeneration. These medications prevent the growth of new blood vessels within the retina.
Stage four retinopathy
Stage four retinopathy describes advanced disease that has caused vision loss. A procedure called viterectomy may be performed to remove part or the whole of the vitreous humor, the transparent jelly-like material that lies within the eyeball behind the lens and in front of the retina. This surgery is useful when there is massive bleeding from the retina or in the case of retinal detachment.
Reviewed by Sally Robertson, BSc