What Can I Do About It? Treatments
Diabetic retinopathy is a diabetes-related eye disease that affects the blood vessels in the retina—the light-sensitive tissue at the back of the eye that is essential for clear vision. Over time, high blood sugar levels can damage these tiny blood vessels, causing them to leak, swell, or become blocked. In advanced cases, new abnormal blood vessels may grow on the retina, increasing the risk of severe vision loss.
Diabetic retinopathy is one of the leading causes of vision loss among adults with diabetes, but it often develops without noticeable symptoms in its early stages. As the disease progresses, symptoms may include:
- Blurred or fluctuating vision
- Floaters or dark spots
- Difficulty seeing at night
- Dark or empty areas in your vision
- Vision loss
Diabetic macular edema (DME) is a complication of diabetic retinopathy and is one of the leading causes of vision loss in people with diabetes. It occurs when damaged blood vessels in the retina leak fluid into the macula, the small central part of the retina responsible for sharp, detailed vision needed for reading, driving, and recognizing faces.
As fluid accumulates, the macula swells (edema), causing blurred or distorted central vision. DME can develop at any stage of diabetic retinopathy but is more common in people with advanced disease.
Proliferative diabetic retinopathy (PDR) is the most advanced stage of diabetic retinopathy and can lead to severe vision loss or blindness if left untreated. It develops when prolonged damage from diabetes causes blood vessels in the retina to close off, reducing the retina’s oxygen supply. In response, the eye produces vascular endothelial growth factor (VEGF), which stimulates the growth of new, abnormal blood vessels (neovascularization).
Although these new blood vessels form in an attempt to restore blood flow, they are fragile and prone to bleeding. They can also lead to scar tissue formation, which may pull on the retina and cause a retinal detachment.
Diabetic retinopathy remains one of the leading causes of vision loss among working-age adults in the United States. Current estimates show:
- Approximately 9.6 million Americans are living with diabetic retinopathy.
- Nearly 1.8 million people have vision-threatening diabetic retinopathy, the advanced stage of the disease that can lead to significant vision loss if left untreated.
- About 1 in 3 adults with diabetes has some degree of diabetic retinopathy.
- The risk of developing diabetic retinopathy increases the longer a person has diabetes and if blood sugar, blood pressure, or cholesterol levels are not well controlled.
- Diabetic retinopathy disproportionately affects certain populations, with higher rates among African Americans, Hispanic/Latino Americans, American Indians, Alaska Natives, and some Asian American communities, largely due to higher rates of diabetes and barriers to healthcare access.
- As the prevalence of diabetes continues to rise, the number of people affected by diabetic retinopathy is expected to increase, making regular comprehensive dilated eye exams more important than ever.
The good news is that early detection and timely treatment can prevent up to 95% of severe vision loss caused by diabetic retinopathy. Annual dilated eye exams and proper diabetes management are the best ways to protect your vision.
Diabetic Retinopathy: Overview