Diabetic Retinopathy

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WHAT IS DIABETIC RETINOPATHY?


Diabetic retinopathy is a complication of diabetes (type 1 & 2). It is a degenerative disease that affects the blood vessels present at the back of the eye: retina.

There are two forms of diabetic retinopathy: the non-proliferative and the proliferative one.
The non-proliferative one is characterized by an increase in permeability and dilatation of blood vessels, as well as by micro-aneurysms, small haemorrhages, exudates, ischaemia and macular oedema.
In the proliferative form, damaged blood vessels close off, causing the growth of new, abnormal blood vessels in the retina, and can leak into the clear, jelly-like substance that fills the center of the eye (vitreous). Macular oedema is also present in the proliferative form.

Diabetic retinopathy is the leading cause of blindness among individuals between 25 and 74 years of age in the industrialized world.



Symptoms may not be present in the early stages of diabetic retinopathy. However, as the condition progresses, symptoms may include:

  • Spots or dark strings floating in your vision (floaters)
  • Blurred vision
  • Fluctuating vision
  • Impaired color vision
  • Dark or empty areas in your vision
  • Vision loss

Diabetic retinopathy usually affects both eyes.

Imaging the retina to learn what is happening inside is crucial to diagnose diabetic retinopathy.
For diabetic patients, regular checking of the retina is necessary to evaluate the stage of retinopathy. Exams such as fundus angiography and OCT imaging are conducted.

Fluorescein fundus angiography using a retinograph provides pictures of blood vessels in the retina after administration of a contrast medium. It is used to determine the degree of extension of the retinopathy and perform follow-up of treatment.

OCT imaging provides cross-sectional images of the retina that show the thickness of the retina and de-tect any leakage into retinal tissue. Later, OCT exams can be used to monitor how treatment is working. Ultrasound imaging can also be used in case of vitreous haemorrhage




Depending on the stage of the disease, various treatment options are available including laser, injections and surgery. Laser can be applied to stop or slow down the leakage of blood vessels (photocoagulation), to eliminate newly formed vessels in the retinal periphery (pan retinal photocoagulation), to reduce macular oedema (subliminal laser therapy).

Vitrectomy is the surgical technique that consists in removing the vitreous in case of retinal haemorrhage and/or retinal detachment.