Diabetic retinopathy involves damage to the eye’s retina due to high blood sugar levels in the body. It is a common complication of diabetes, affecting millions of people with both type 1 and type 2 diabetes.

Diabetic retinopathy affects the blood vessels in the retina of the eye. Over time, high blood sugar levels, which can occur with diabetes, may damage the retina’s blood vessels.

This damage may cause the blood vessels to leak fluid, which can cause swelling to occur in the eye. The damage may also prevent blood and nutrients from getting to the retina. In later stages of the disease, new, abnormal vessels may form. The changes to the retina’s blood vessels can lead to vision loss.

In this article, we will discuss the prevalence of diabetic retinopathy, its causes and risk factors, and treatment options.

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Diabetic retinopathy is a common complication of diabetes. The exact prevalence varies based on the source. Some estimates suggest that over 50% of people with diabetes develop diabetic retinopathy at some point in their life.

A 2022 systematic review and meta-analysis of international databases found that one-third of people with diabetes have diabetic retinopathy. Individuals over the age of 60 have a higher risk than younger people.

The rates for diabetic retinopathy may also vary depending on how long a person has had diabetes. The longer a person has diabetes, the greater their risk of developing diabetic retinopathy. For example, adults over age 45 that had a diagnosis of diabetes for 10 years or greater were three times more likely to develop diabetic retinopathy than people that had diabetes for fewer than 10 years.

Some evidence suggests that worldwide, the prevalence of diabetic retinopathy is 77.3% in people with type 1 diabetes and 25.1% in people with type 2 diabetes. In the United States, diabetic retinopathy affects about 8 million people.

Continued high blood sugar levels can cause diabetic retinopathy. If too much sugar accumulates in the tiny blood vessels of the retina, it can cause them to leak or bleed. This damage can also lead to a reduction of oxygen levels in the eye. To compensate, the eye may then grow new blood vessels that are weaker and leak or bleed more easily. As such, anyone with diabetes is at risk for diabetic retinopathy.

Doctors have also identified additional risk factors, such as:

Diabetic retinopathy is the leading cause of vision loss in working-age adults. However, in the early stages of the disease, symptoms may not occur. This is why regular eye exams are vital.

Usually, diabetic retinopathy affects. When symptoms develop, they may include:

  • blurred vision
  • difficulty reading
  • trouble seeing, which comes and goes
  • black or gray floaters in the field of vision
  • dark or blank areas of vision

Doctors diagnose diabetic retinopathy through a dilated eye exam. The doctor puts eye drops in the eyes, which widen the pupil. Dilation allows the eye doctor to clearly see the inside of the eye and the retina when using a fundoscope. This allows them to assess the health of the blood vessels in the eye.

The eye doctor may also order an optical coherence tomography, which is a painless scan to assess retinal thickness. This test helps identify swelling in the macula. Doctors may also recommend a fluorescein angiography to view the blood vessels in the retina.

The goal of treatment for diabetic retinopathy is to slow how fast the disease progresses and prevent vision loss. Diabetic retinopathy can progress through different stages. The two types of diabetic retinopathy are known as nonproliferative and proliferative.

Click here to learn more about the differences between nonproliferative and proliferative diabetic retinopathy.

The advanced stage of the disease, called proliferative diabetic retinopathy, involves the growth of new, abnormal blood vessels. A 2018 review indicates proliferative diabetic retinopathy occurs more often with type 1 diabetes. The risk of vision loss increases with the duration of high blood sugar levels, causing the condition to progress. Vision loss occurs most often with proliferative diabetic retinopathy.

Treatment options may include:

  • Medications: Doctors inject medications, called vascular endothelial growth inhibitors, into the eye to stop the development of new blood vessels.
  • Laser therapy: To reduce swelling, a doctor can use lasers to shrink blood vessels and stop them from leaking.
  • Vitrectomy: This is a form of surgery that involves removing blood and other fluid from the vitreous. The vitreous is the fluid that fills the space between the retina and the lens. Doctors may also remove scar tissue, if present, that is pulling on the retina.

According to the National Eye Institute (NEI), managing diabetes is the best way to lower the risk of developing diabetic retinopathy. Managing diabetes may include:

  • taking insulin, or other medications, as instructed by a healthcare provider
  • getting regular exercise
  • following a nutritionist’s recommended nutritional plan
  • treating high blood pressure, which also contributes to diabetic retinopathy
  • attending regular eye exams to monitor eye health and initiate treatment, if necessary

Diabetic retinopathy can develop due to complications from diabetes. High blood sugar levels may damage the retina’s blood vessels, causing them to leak and swell. The longer a person has diabetes, the greater their risk of developing diabetic retinopathy. In advanced cases, diabetic retinopathy can cause vision loss.

Treatment can help slow the progression of the disease. Treatment involves managing diabetes, such as through controlling blood sugar levels and other options, such as medications and surgery.