What Is Diabetic Retinopathy?
Diabetic retinopathy, the most common diabetic eye disease, occurs when blood vessels in the retina change. Sometimes these vessels swell and leak fluid or even close off completely. In other cases, abnormal new blood vessels grow on the surface of the retina.
The retina is a thin layer of light-sensitive tissue that lines the back of the eye. Light rays are focused onto the retina, where they are transmitted to the brain and interpreted as the images you see. The macula is a very small area at the center of the retina. It is the macula that is responsible for your pinpoint vision, allowing you to read, sew or recognize a face. The surrounding part of the retina, called the peripheral retina, is responsible for your side—or peripheral—vision.
Diabetic retinopathy usually affects both eyes. People who have diabetic retinopathy often don’t notice changes in their vision in the disease’s early stages. But as it progresses, diabetic retinopathy usually causes vision loss that in many cases cannot be reversed.
Diabetic eye problems
There are two types of diabetic retinopathy:
Background or nonproliferative diabetic retinopathy (NPDR)
Nonproliferative diabetic retinopathy (NPDR) is the earliest stage of diabetic retinopathy. With this condition, damaged blood vessels in the retina begin to leak extra fluid and small amounts of blood into the eye. Sometimes, deposits of cholesterol or other fats from the blood may leak into the retina.
NPDR can cause changes in the eye, including:
- Microaneurysms: small bulges in blood vessels of the retina that often leak fluid.
- Retinal hemorrhages: tiny spots of blood that leak into the retina.
- Hard exudates: deposits of cholesterol or other fats from the blood that have leaked into the retina.
- Macular edema: swelling or thickening of the macula caused by fluid leaking from the retina’s blood vessels. The macula doesn’t function properly when it is swollen. Macular edema is the most common cause of vision loss in diabetes.
- Macular ischemia: small blood vessels (capillaries) close. Your vision blurs because the macula no longer receives enough blood to work properly.
Many people with diabetes have mild NPDR, which usually does not affect their vision. However, if their vision is affected, it is the result of macular edema and macular ischemia.
Watch how macular edema and macular ischemia affect your eyes.