Diabetic Retinopathy

People with diabetes (both type 1 and type 2) can develop diabetic retinopathy, a major cause of visual impairment and blindness in working-age individuals.

This condition occurs when high blood glucose levels over time damage the retinal blood vessels, harming the retina—the light-sensitive tissue at the back of the eye that is essential for vision.

Over time, retinal vessels can:

• Weaken and swell, forming microaneurysms
• Leak fluid or blood, causing macular edema, which affects central vision
• Close off, leading to retinal ischemia
• Stimulate the growth of abnormal blood vessels (neovascularization), which are fragile and prone to rupture, causing fibrovascular proliferation, intraocular hemorrhage, and/or tractional retinal detachment.

These changes may occur without symptoms in the early stages, making early diagnosis via regular eye exams essential, even in the absence of visual complaints.

Prevention

• Strict control of blood sugar, blood pressure, and cholesterol is crucial to slowing disease progression.
• An eye exam with fundus evaluation (often using OCT or angiography) is the first step to detect early signs and plan personalized treatment.

Treatment options depend on disease severity:

depend on disease severity:

• Intravitreal injections of anti-VEGF agents or corticosteroids for macular edema;
• Retinal laser photocoagulation to treat ischemic areas and prevent neovascularization;
• Vitrectomy surgery in advanced cases, such as with vitreous hemorrhage or retinal detachment.