Diabetic retinopathy | Causes, symptoms, and treatment

What is diabetic retinopathy?

Diabetic retinopathy is a condition in which the blood vessels supplying the retina are damaged. These blood vessels can then leak blood or other fluid which can affect the vision and cause damage to the retina. Diabetic retinopathy is one of the most common causes of blindness in the UK.

What are the stages of diabetic retinopathy?

There are different stages of diabetic retinopathy that may be experienced. The main stages in order are background retinopathy, pre-proliferative retinopathy, and proliferative retinopathy:

Background retinopathy

At this stage, the blood vessels supplying the retina start swelling and can bleed slightly. At this stage, eyesight is not affected but there is a higher chance of the condition progressing over the next few years. We recommend having your eyes checked by a retinal specialist to monitor and prevent the condition from worsening.

Pre-proliferative retinopathy

At the pre-proliferative or non-proliferative stage, there could be increased bleeding into the retina. More frequent retinal screening is needed, usually every 3 or 6 months, to monitor the condition.

Proliferative retinopathy

At this stage, scar tissue and new fragile blood vessels grow on the retina that are prone to bleeding. This bleeding can lead to conditions such as retinal detachment and vitreous haemorrhage; because of this, there’s a high risk of vision loss.

What are the causes of diabetic retinopathy?

Diabetic retinopathy is a complication of diabetes. The high blood sugar associated with diabetes causes damage of the retinal blood vessels leading to the growth of abnormal blood vessels that can bleed. This bleeding can cause vitreous haemorrhage and other eye complications.

What are the symptoms of diabetic retinopathy?

At early stages of diabetic retinopathy, there may not be any symptoms. At more advanced stages, the following symptoms may appear:

• An increase in dark spots floating across your vision (eye floaters)
• Blurred or distorted vision
• Fluctuation of vision from clear to blurry
• Blank areas in the field of view
• Loss of vision

Treatment options for diabetic retinopathy

At all stages of diabetic retinopathy, diabetes needs to be monitored and managed. Further treatment is provided at the proliferative stage. Treatments include:

• Vitrectomy surgery to remove the vitreous gel within the eye along with any blood in the eye. Removing the vitreous also serves to provide the surgeon access to remove scar tissue and for laser treatment
• Laser treatment to remove the new abnormal blood vessels from the retina
• Anti-VEGF injections (Avastin, Lucentis and Eylea) into the eyes stop the leakage that cause swelling of the central retina and growth of abnormal blood vessels, preventing further damage to the retina as well as potentially improving vision

What to expect after diabetic retinopathy treatment

Laser treatment is usually painless and local anaesthetic is used to numb the eyes. Usually you can return home the same day after treatment.

Learn more about what to expect after the VEGF injections here and after vitrectomy here.