DIABETIC RETINOPATHY HAS FOUR STAGES:
MILD NONPROLIFERATIVE RETINOPATHY
At this earliest stage, microaneurysms occur. They are small areas of balloon-like swelling in the retina’s tiny blood vessels.
MODERATE NONPROLIFERATIVE RETINOPATHY
As the disease progresses, some blood vessels that nourish the retina are blocked.
SEVERE NONPROLIFERATIVE RETINOPATHY
Many more blood vessels are blocked, depriving several areas of the retina with their blood supply. These areas of the retina send signals to the body to grow new blood vessels for nourishment.
PROLIFERATIVE RETINOPATHY
At this advanced stage, the signals sent by the retina for nourishment trigger the growth of new blood vessels. This condition is called proliferative retinopathy. These new blood vessels are abnormal and fragile. They grow along the retina and along the surface of the clear, vitreous gel that fills the inside of the eye. By themselves, these blood vessels do not cause symptoms or vision loss. However, they have thin, fragile walls. If they leak blood, severe vision loss and even blindness can result.
The blood vessels become blocked, so sufficient oxygen doesn’t reach the retina. In other words, hypoxia develops. Remember, if hypoxia occurs to your brain, the result would be a loss of consciousness. Well, if hypoxia occurs to your retina, there will eventually be visual consequences.
However, in response to the hypoxia, a signal is sent to release a chemical called vascular endothelial growth factor; aka VEGF. This substance is responsible for creating the new blood vessels that grow on the surface of the retina and along the vitreous gel inside the eye. The new blood vessels grow in order to feed the starving retina. Unfortunately, these are not normal or healthy blood vessels. The new blood vessels are formed in order to carry oxygen to the retina; however, unhealthy consequences can and usually occur secondary to their formation.
The new blood vessels are fragile, thus lending themselves to leaking and breaking easily. Additionally, not only do the vessels grow on the surface of the retina, but they also grow upward into the vitreous. As a result, a tugging can occur between the vitreous gel and the new blood vessels. Consequently, the new blood vessel is torn, and blood pours out into the vitreous gel and retina. As a result, the patient is likely to very poor vision to only light perception.
IF YOU HAVE DIABETIC RETINOPATHY, YOU MAY NEED AN EYE EXAM MORE OFTEN.
People with proliferative retinopathy can reduce their risk of blindness by 95 percent with timely treatment and appropriate follow-up care. Better control of blood sugar levels slows the onset and progression of retinopathy. The people with diabetes who kept their blood sugar levels as close to normal as possible also had much less kidney and nerve disease. Better control also reduces the need for sight-saving laser surgery. Other studies have shown that controlling elevated blood pressure and cholesterol can reduce the risk of vision loss. Controlling these will help your overall health as well as help protect your vision.
Treatment for diabetic retinopathy is based on the type of retinopathy present. At East Florida Eye Institute, we are utilizing ground breaking therapies to treat this condition. To learn more, click here.