Stages of Diabetic Retinopathy | National Diabetes Month

November is National Diabetes Month. Learning more about the stages of diabetic retinopathy and ways to prevent the condition from progressing can save your vision. 
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Diabetic retinopathy is a possible complication of diabetes. Over time, high blood sugar can adversely affect the blood vessels in the retina. The retina is the layer of cells at the back of the eye. It plays a key role in vision. 

What are the symptoms of diabetic retinopathy? 

Diabetic retinopathy may not cause any symptoms at first. Some people may not be aware they have the condition, but as the condition progresses, symptoms appear and may include:

• Spots or floaters in your vision
• Dark areas of vision
• Blurred vision
  
• Vision loss 

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Stages of diabetic retinopathy 

Diabetic retinopathy is broken down into stages. Some experts break it down into four stages, but the American Academy of Ophthalmology divides diabetic retinopathy into two stages.

​Non-proliferative retinopathy

Non-proliferative is the early stage of the disease. This stage of diabetic retinopathy involves small blood vessel leaks. This causes the retina to swell. If the macula swells, it is referred to as macular edema. During this stage, the retinal blood vessels can also close off, which prevents the blood from reaching the retina.

Some people may not be aware they have diabetic retinopathy at this stage. They may not have any symptoms. In other cases, symptoms may start and can include blurry vision.  
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Proliferative retinopathy

This is an advanced stage of diabetic retinopathy. Symptoms occur during this stage.

The proliferative stage involves the retina growing abnormal new blood vessels. This process is called neovascularization. The new blood vessels are fragile. They may bleed into the vitreous, which is the gel-like substance in the middle of the eye.

The bleeding into the eye can vary in severity. If bleeding is light, it can cause you to see dark floaters. If the bleeding is significant, vision loss may occur. The new abnormal blood vessels can also cause scar tissue, leading to a detached retina.

When diabetic retinopathy develops into the proliferative stage, it can lead to central and peripheral vision loss.  
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Treatment 

Treatment for diabetic retinopathy involves following a diabetic management plan to control blood sugar levels. Maintaining good blood sugar control can slow the progression of the disease and may prevent vision loss. Good blood sugar control may include following nutritional recommendations, exercise, and diabetic medication. 

Additional treatment may involve your retina specialist using an anti-VEGF (vascular endothelial growth factor) medicine to control your diabetic retinopathy. This type of medicine may help decrease swelling of the retina and control abnormal blood vessels.

If medication is not effective, laser surgery may be recommended. Laser surgery involves sealing off the leaking blood vessels. This may decrease retinal swelling. Laser surgery may also prevent blood vessels from growing back. In some cases, the surgery needs to be repeated more than once.  
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General prevention 

Preventing diabetes is the best way to prevent diabetic vision complications. Diabetes prevention tips include:

• Keeping your weight in a healthy range
• Do not smoke
• Getting regular exercise
• Limiting foods high in sugar and trans fat
• Only drink alcohol lightly
• Eating lots of veggies, lean protein, and fresh fruit

If you do have diabetes, work closely with your doctor to keep your blood sugar levels in the healthy range. It is also important to see an eye doctor as soon as you are diagnosed with diabetes. Getting a baseline eye exam is helpful to spot any changes that occur down the road.

Regular eye exams also help diagnose diabetic retinopathy early. Getting treatment for diabetic retinopathy as soon as possible may also prevent vision loss. 

If you would like to ask whether an appointment with one of our eye doctors would be appropriate at this time, call our office at 508-746-8600.