Diabetic retinopathy

Alternative names
Retinopathy - diabetic

Definition
Diabetic retinopathy is progressive damage to the eye’s retina caused by long-term diabetes. It can cause blindness.

Causes, incidence, and risk factors

Diabetic retinopathy is the leading cause of blindness in working-age Americans. People with both type 1 diabetes and type 2 diabetes are at risk for this condition.

The likelihood and severity of retinopathy increase with the duration of diabetes and is likely to be worse if your diabetes is poorly controlled. Almost all people who have had diabetes for more than 30 years will show signs of diabetic retinopathy.

Diabetic retinopathy is caused by damage to blood vessels of the retina. In the earlier and less severe type (non-proliferative diabetic retinopathy), the existing blood vessels become porous and leak fluid into the retina, which leads to blurred vision.

In the more advanced and severe type (proliferative retinopathy), growth of new blood vessels occurs within the eye. These new vessels are fragile and can hemorrhage, which causes loss of vision and scarring.

Symptoms

     
  • Decreased visual acuity  
  • Floating spots in the vision (floaters)

Many people have no preliminary symptoms before a major hemorrhage in the eye. This is why everyone with diabetes should be screened regularly.

Signs and tests

     
  • Ophthalmologic examination  
  • Retinal photography

Treatment

The goal of treatment is to control your diabetes and associated high blood pressure. Such treatment usually does not reverse existing damage, but will slow the progression of the disease. Laser surgery may be used to seal leaking vessels or to eradicate abnormal fragile vessels.

Surgical treatment (vitrectomy) is used in cases of hemorrhage into the eye. It may also be used to repair retinal detachment caused by hemorrhage and subsequent scarring.

People with diabetes should see an ophthalmologist for a dilated examination of the retina once per year to reduce the chances of serious vision loss.

Expectations (prognosis)

The outcome may be improved by good control of diabetes and high blood pressure. Some degree of diabetic retinopathy usually becomes evident after 10 years and is nearly universal in people who have diabetes mellitus for more than 30 years.

Diabetic retinopathy can lead to blindness without treatment. Frequent examination and laser surgery, if necessary, can prevent blindness in most cases.

Complications

     
  • Glaucoma  
  • Retinal detachment  
  • Blindness

Calling your health care provider
Call for an appointment with an ophthalmologist (eye doctor) if you have diabetes and you have not seen an ophthalmologist in the past year.

Prevention
By controlling diabetes and high blood pressure, you can slow the progression of retinopathy.

Johns Hopkins patient information

Last revised: December 5, 2012
by Potos A. Aagen, M.D.

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