A Progressive Condition

Retinopathy progresses through four stages:

  • Mild Nonproliferative Retinopathy – This is the stage in which small areas of balloon-like swelling occur in tiny blood vessels in the retina.
  • Moderate Nonproliferative Retinopathy – At this stage, blood vessels that supply nutrients to the eye become closed off and blocked.
  • Severe Nonproliferative Retinopathy – More and more blood vessels cease to function, cutting off blood supply to the retina. The retina signals the body to grow new blood vessels.
  • Proliferative Retinopathy – New blood vessels appear, but they are abnormal and weak. They grow along the clear gel that fills the eye (the vitreous). When the thin, fragile walls of the blood vessels begin to leak blood, severe vision loss or blindness can occur.  
    • Eye disorders attributable to diabetic retinopathy include: diabetic macular edema, cataracts, and glaucoma

    Diabetic Macular Edema

    Macular edema occurs when blood vessels in the retina begin to leak into the macula, the part of the eye responsible for detailed central vision. When this occurs in a patient with diabetes, it is referred to as diabetic macular edema or DME and is the major cause of vision loss in people with diabetic retinopathy. The lifetime risk for diabetics to develop DME is about 10%.

    These leaks cause the macula to thicken and swell, progressively distorting acute vision. While the swelling may not lead to blindness, the effect can cause a severe loss in central vision. DME is classified into two types; focal and diffuse. Focal macular edema is caused by vascular abnormalities, primarily microaneurysms, which tend to leak fluid whereas diffuse macular edema is caused by dilated capillaries in the retina.

    Cataracts

    What is a cataract?A cataract is a progressive clouding in the lens of the eye that blocks light, causing blurry or distorted vision. While cataracts can be a natural result of aging, people diagnosed with diabetes are 60% more likely to develop cataracts, usually at a younger age, and have them progress faster. Cataract surgery, to remove the clouded lens and replace it with an artificial lens implant, is the only cure for cataracts and is the most frequently performed surgical procedure in the United States.

    Glaucoma

    Glaucoma is an increase of intraocular pressure that builds in the eye, damaging the optic nerve and causing impaired vision and eventual blindness if not controlled. People with diabetes are 40% more likely to develop glaucoma than those who don’t have the disease and the risk of glaucoma also increases with age. So the longer a person has diabetes, the more likely they are to develop glaucoma.

    "Diabetic macular edema or DME is the major cause of vision loss in people with diabetic retinopathy".